Navigating the Transition to Middle Age in the Strong African American Healthy Adults Project (SHAPE) - African Americans in the rural South are often not included in studies focused on the developmental origins of cognitive decline and cardiometabolic disease, but they experience among the lowest life expectancies in the US among the lowest life expectancies in the US, a consequence of morbidity from chronic diseases of aging (CDAs) and Alzheimer’s disease and related dementias (ADRD). This omission is concerning because the pathways leading to chronic disease may be unique for African Americans. Emerging evidence suggests that both CDAs and ADRD are conditions that develop over the lifespan. Wear and tear from chronic stress, beginning in childhood and continuing throughout the life course, weathers multiple physiological systems, increasing disease vulnerability, including risk for cardiovascular disease, diabetes, and dementia. Since 2001, the Strong African American Families Healthy Adult Project (SHAPE) has followed a cohort of rural African American youth participating in an investigation of risk, resilience, and development. When participants were age 19, we expanded our investigations to address biological weathering. We found that exposure to family economic hardship and environmental stressors in late childhood and adolescence forecast biological weathering during emerging adulthood as evidenced by allostatic load, inflammatory activity, and epigenetic aging. For rural African Americans, the fourth decade of life has significant potential to affect biological weathering and CDA/ADRD vulnerabilities for better or worse. The influences of poverty, community disadvantage, and interpersonal stressors combine to render rural African Americans’ transitions to middle age especially challenging and stressful. Despite challenging conditions, many SHAPE participants will maintain in good health and some may improve their health. During the next 5 years, SHAPE participants will be exposed to continued and, in some cases, amplified contextual stress. Some participants will evince escalation in their weathering trajectories and the emergence of health problems, whereas others will not. The proposed research is designed to investigate the reasons why by collecting two waves of additional data when SHAPE participants are ages 35 and 37. Data collection will include biological markers of weathering, clinical indicators of cardiometabolic health, behavioral indicators of cognitive function, and reports of functional limitations. Participants will also provide information about psychosocial functioning and behavioral risk and protective factors. Our specific aims are to leverage this “deeply phenotyped” longitudinal study to: (a) test hypotheses regarding precursors of pre-disease warning signs, functional limitations, and cognitive decline; (b) evaluate the interconnectedness of physical health and cognitive decline by evaluating shared biological processes that might foreshadow risk; and (c) evaluate protective factors that prevent stress exposure from affecting rural African American adults’ health and cognition as they enter midlife.
