The Epidemiology of Cognitive Decline in African Americans: Identifying Risk and Protective Factors - PROJECT SUMMARY/ABSTRACT By 2060, 44% of older U.S. adults will be non-Hispanic White compared with 60% in 2020. Cognitive decline in this growing racially and ethnically diverse older population is a major public health concern. Blacks are disproportionately affected by Alzheimer’s disease and related dementias (ADRD), and potentially experience a faster rate of cognitive decline than other groups. Yet, little is known is about the mechanisms underlying this increased prevalence. Genetic mechanisms do not account entirely for the higher risk of decline and ADRD in older Black adults, suggesting that other factors may explain this variation. However, the majority of cognitive aging research derives from studies that have compared Blacks to Whites versus exploring within-group variability in health conditions, biological, and psychosocial risk and protective factors that may account for these differences. This study's overall goal is to clarify risk and protective factors underlying cognitive decline in Blacks by: (1) Examining the relation between high blood pressure (HBP) and domain-specific cognitive decline and exploring how serious life events and social support modify the HBP-cognition association; (2) Exploring the relation between inflammation and cognitive decline and how HBP mediates the relation between serious life events and cognition; and (3) Identifying the consequence of perceived stress on changes in cognition and evaluating whether HBP and social support moderates the stress-cognition relationship. The research plan will leverage valuable secondary data from two nationally recognized studies of older adults. This K01 Award application will facilitate the training and professional development of Dr. Byrd to launch her career as an independent investigator in the field of aging, cognition, and ADRD. The five-year training plan will fill gaps in (1) cognitive decline and aging research and (2) stress and coping theories, while building on her methodological strengths to include (3) advanced longitudinal methods. Dr. Byrd will complete the proposed research in the rich training environment of Arizona State University (ASU), with co-primary mentorship from David Coon, PhD, Professor and geropsychologist (ASU) and Roland J. Thorpe, PhD, Professor of Health, Behavior and Society and minority aging expert (John Hopkin’s University) and nationally and internationally recognized secondary mentors Peter Lichtenberg, PhD (geriatric neuropsychologist), Keith Whitfield, PhD (expert on cognition among Blacks) ,Toni Antonucci, PhD (social relations across the lifespan) and renowned biostatistician Wassim Tarraf, PhD. The proposal addresses Goals B and F of the NIA Strategic Directions for Research on Aging, which calls for research that seeks to understand 1) the effects of personal, interpersonal, and societal factors on aging and 2) health disparities among older adults. Our research has the potential to influence individual outcomes as well as affect policies and programs aimed at improving cognitive health for the aging population, particularly for Black Americans who are at greatest risk for cognitive decline and ADRD.
