PROJECT SUMMARY
Latinos living in the 50 United States (US; hereinafter States), the largest racial/ethnic minority US population,
are 1.5 times more likely to have Alzheimer’s disease than non-Latino whites. Latinos in the States exhibit
unique profiles of Alzheimer’s disease and related dementias (ADRD) disparities across ethnic backgrounds
(namely, Cubans, Dominicans, Mexicans, Puerto Ricans, and South and Central Americans). For example,
Puerto Ricans are the Latino background with the lowest cognitive scores and highest prevalence of mild
cognitive impairment and cardiovascular disease (CVD) risk factors-- long associated with higher ADRD risk.
Thus, it is not surprising that ADRD is also a growing crisis among Latinos living in the US territory (island) of
Puerto Rico (PR). In fact, the age-adjusted AD mortality rate in PR is double that of Latinos in the States.
Unfortunately, research on protective factors that may serve as targets for promoting cognitive and brain health
among Latinos in the States is scant and even less is known among Latinos in PR. As an early stage
investigator, born and raised in PR, with doctoral training in community health sciences and post-doctoral
training on CVD epidemiology, this K01 would the provide new skills and training in theories of resilience and
reserve as well as content knowledge on normative cognitive aging, brain structure and neuroimaging, and
protective factors for healthy aging. This K01 would also achieve the overall research goal of examining the
mechanisms through which protective factors shown important in older non-Latino whites, i.e., favorable body
composition, better psychological health, and higher levels of cognitive enrichment, support cognitive and brain
health in middle-aged and older Latinos (ages 45+) with an emphasis on PR. Specifically, Aim 1 is focused on
resilience to age; we will investigate baseline protective factors related with maintenance of cognitive function
over a 7-year follow-up period (i.e., cognitive resilience to age) and examine whether protective factors modify
the cross-sectional relation of age with brain structure (i.e., brain resilience to age) using previously collected
data from the largest epidemiological study of Latino health in the States, the Hispanic Community Health
Study/Study of Latinos (HCHS/SOL) Visits 1 and 2 and its NIA-funded SOL-INCA and SOL-INCA MRI ancillary
studies. Aim 2 is focused on cognitive reserve; we will test whether protective factors modify the cross-
sectional relations of brain structure with cognition by leveraging data from SOL-INCA MRI and SOL-INCA.
Aim 3 is focused on PR, we will administer the HCHS/SOL cognitive battery in the NHLBI-funded PROSPECT
cohort, an island-wide longitudinal epidemiological study of health, to estimate cognition and compare the
protective factors-cognition relations between Puerto Ricans in PROSPECT and HCHS/SOL. This research is
responsive to the priority areas of the NIA of identifying protective factors associated with successful cognitive
aging in ADRD disparities populations. The proposed research will provide preliminary data to conduct a larger
epidemiological R01 study on resilience and reserve among adults living in PR.