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  • 1
    Online Resource
    Online Resource
    Relationship of daily, institutional and structural racism with cognition in ethnically/racially diverse middle‐age Americans
    Wiley ; 2022
    In:  Alzheimer's & Dementia Vol. 18, No. S11 ( 2022-12)
    Details
    In: Alzheimer's & Dementia, Wiley, Vol. 18, No. S11 ( 2022-12)
    Abstract: Racism is a social determinant of health that operates at multiple levels ‐ interpersonal, institutional, structural ‐ producing stress and limiting access to resources that have dire biopsychosocial effects for historically marginalized communities. Research on older adults suggests interpersonal and structural racism, separately, are associated with worse cognition and may be an underlying reason for racial/ethnic disparities in cognitive aging. An evidence gap remains on how multilevel racism influences cognition throughout the life‐course. Method We assessed 942 middle‐aged community‐dwelling adults (mean age = 55, SD = 11; 64% women; 19% non‐Latinx White; 23% non‐Latinx Black; 55% Latinx). Daily interpersonal racism was ascertained by the Everyday Discrimination (ED) scale, institutional racism by the Major Discrimination (MD) Scale, and structural racism in early life was measured by residential segregation of the census block group in which parents of our respondents lived. Our outcomes were derived from a neuropsychological evaluation with the Digit Span assessing attention and working memory, and delayed recall from the Selective Reminding Test capturing episodic memory. Two fluency measures (animal and letter) were also studied. The relationship between multilevel racism indicators and cognition was estimated using age‐adjusted linear regression models. Additional models were stratified by racialized/ethnic group and added education as a covariate. Result Exposure to multilevel racism varied across racialized/ethnic group. Non‐Latinx Black respondents scored highest on interpersonal racism, second highest on institutional racism, and were more likely to grow up in segregated residential areas with higher proportion of other Black residents. Exposure to interpersonal (Figure A) and institutional racism (Figure B) was associated with lower memory scores and these associations were driven by non‐Latinx Black respondents. Structural racism was associated with lower episodic memory in the full sample. Conclusion Our findings indicate that multilevel racism related to cognition and due to higher exposure among marginalized groups may be a substantial driver of racial/ethnic disparities in cognitive health. In future, additive and multiplicative effects of our exposures will be examined.
    Type of Medium: Online Resource
    ISSN: 1552-5260 , 1552-5279
    URL: Issue
    URL: Article
    DOI: 10.1002/alz.v18.S11
    DOI: 10.1002/alz.067224
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2201940-6
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  • 2
    Online Resource
    Online Resource
    Loneliness predicts stronger negative associations between cerebrovascular, but not Alzheimer’s, pathology and cognition
    Wiley ; 2022
    In:  Alzheimer's & Dementia Vol. 18, No. S8 ( 2022-12)
    Details
    In: Alzheimer's & Dementia, Wiley, Vol. 18, No. S8 ( 2022-12)
    Abstract: Alzheimer’s disease (AD) and cerebrovascular disease are the two most common pathologies underlying dementia. Loneliness is associated with faster cognitive decline and greater AD risk independent of pathology. Risk reduction efforts would benefit from knowing whether loneliness exacerbates the cognitive impact of pathology. Our objective was to characterize the interaction between loneliness and AD or cerebrovascular pathology on cognitive performance. Methods Participants with neuropathological data were drawn from the Religious Orders Study, the Memory and Aging Project, and the Minority Aging Research Study (Table 1). Loneliness was assessed with a modified version of the de Jong‐Gierveld Loneliness Scale. Amyloid and tau pathology were assessed jointly with the NIA‐Reagan scale as high/intermediate likelihood or low likelihood/no AD. Chronic infarcts and chronic microinfarcts were each assessed as present or not present. Composite domain scores for episodic memory, working memory, semantic memory, perceptual speed, and perceptual orientation were obtained from the study visit proximal to death. Separate general linear models were run for each domain and each pathology, including an interaction between loneliness and pathology and adjusting for covariates. Results Greater loneliness was associated with older age and lower education, and loneliness was greater in men compared to women, but not different by race or APOE‐ε4 (2). Loneliness was not associated with AD or cerebrovascular pathology (Table 3). Greater loneliness was independently associated with lower cognitive scores in all domains. Greater pathology was independently associated with lower episodic memory and semantic memory scores, while cerebrovascular disease was not independently associated with cognitive scores. We additionally found that negative associations between microinfarcts and cognitive scores in working memory, semantic memory, and perceptual orientation were stronger among individuals with greater (Table 4). Conclusions Negative associations between loneliness and cognition are apparent across domains and independent of pathology. While loneliness does not appear to be related to AD or cerebrovascular pathology directly, it may increase susceptibility to cognitive impairment due to microinfarcts. Social support‐based interventions may benefit optimal brain aging, particularly in older adults exposed to greater loneliness.
    Type of Medium: Online Resource
    ISSN: 1552-5260 , 1552-5279
    URL: Issue
    URL: Article
    DOI: 10.1002/alz.v18.S8
    DOI: 10.1002/alz.066983
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2201940-6
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  • 3
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    Online Resource
    Associations between intergenerational transmission of AD, type 2 diabetes, and cognitive function among non‐Hispanic Black adults in midlife
    Wiley ; 2022
    In:  Alzheimer's & Dementia Vol. 18, No. S7 ( 2022-12)
    Details
    In: Alzheimer's & Dementia, Wiley, Vol. 18, No. S7 ( 2022-12)
    Abstract: Type 2 diabetes (T2D) and parental history of Alzheimer’s disease (AD) are independent risk factors for late‐life cognitive impairment. The presence of T2D may strengthen the association of parental AD risk on cognition through pathways of vascular function, insulin signaling, and amyloid β/tau metabolism. Examining the independent and interactive association of parental AD risk and T2D on cognitive function, specifically in non‐Hispanic Black adults may advance our understanding of their contribution to the disproportionate rates of AD in this group. We hypothesize that parental AD risk and T2D would be independently associated with worse cognition and that the association between parental AD risk and cognition would be stronger in participants with T2D. Method Participants comprised non‐Hispanic Black adults (N = 331; 25.8% with T2D; Table 1) in the Offspring Study who are the adult children of participants in the Washington Heights Inwood Columbia Aging Project (WHICAP). AD risk was operationalized as parental memory performance residualized for age and education and assessed at their last WHICAP visit. Participant T2D was based on self‐reported physician diagnosis and cognition was assessed with measures of attention, language, and memory. Cognitive test scores were residualized for age and education (Table 1). Linear regression models quantified the independent associations and interaction of AD risk and T2D on offspring cognition. Result T2D was associated with lower language ( B = ‐0.13, 95% CI: [‐0.55, ‐0.08]) and memory ( B = ‐0.45, 95% CI: [‐0.72, ‐0.17]) scores, but AD risk was not associated with cognition in any domain. However, AD risk was associated with lower language scores among participants without T2D, but not in participants with T2D ( B = ‐0.36, 95% CI [‐0.71, ‐0.02]; Figure 1). No interaction was observed for AD risk and T2D with memory and attention (Figure 2). Conclusion Our results suggest that among middle‐aged non‐Hispanic Black adults, AD risk is associated with lower language performance in individuals without T2D. The association between AD risk and cognition may be masked by exposure to risk factors, such as T2D.
    Type of Medium: Online Resource
    ISSN: 1552-5260 , 1552-5279
    URL: Issue
    URL: Article
    DOI: 10.1002/alz.v18.S7
    DOI: 10.1002/alz.068307
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2201940-6
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