INS NYC 2024 Program

Custom Content	Poster Session 11 Program Schedule 02/17/2024 10:45 am - 12:00 pm Room: Shubert Complex (Posters 1-60) Poster Session 11: Cultural Neuropsychology \| Education/Training \| Professional Practice Issues Final Abstract #6 Poster Symposium: Summary Intersecting Determinants of Health: The Influences of Community, sex, race, and Ethnicity in Aging Outcomes, a Health & Aging Brain Study – Health Disparities project Category: Dementia (Alzheimer's Disease) Keyword 1: diversity Keyword 2: dementia - Alzheimer's disease Keyword 3: minority issues Summary Abstract: Objective: Demographic factors including age, sex, race, and ethnicity are commonly considered in clinical practice and aging research, given their associations with Alzheimer’s disease (AD) risk and outcomes. There is an emerging literature associating contextual-level social determinants of health (SDoH) such as neighborhood disadvantage (ND), which is strongly linked to structural and systemic inequities, with health and aging outcomes. However, relatively little is known about these influences on brain aging, and even less is known about how they intersect with sex, race, and ethnicity. As healthcare moves into the era of personalized medicine, understanding how these varying dimensions of diversity intersect to influence one’s aging trajectory is a major area of interest. In this symposium, we present a series of projects that specifically address several of these knowledge gaps. Participants and Methods: Data presented are from the Health & Aging Brain Study – Health Disparities (HABS-HD), the largest prospective study focused on the study of aging in the 3 largest racial and ethnic groups in the United States, non-Hispanic Blacks (NHB), Hispanics, and non-Hispanic Whites (NHW). Community-dwelling adults over the age of 50 are recruited into HABS-HD using community-based participatory research methods and followed longitudinally. Standard protocols include clinical exams with cognitive testing, blood draw for clinical labs and AD biomarkers, and brain imaging collected every 24 months. Neighborhood disadvantage is assessed using the Area Deprivation Index (ADI) based on the participant’s current address at the time of visit. Baseline data were used in all analyses. Results: Across projects, Hispanic individuals were more likely to reside in disadvantaged areas compared to NHWs. We first found that NHW and Hispanic individuals aging in more disadvantaged areas had worse cognition compared to those in less disadvantaged areas, which was more pronounced in Hispanic individuals. We also found that women showed better verbal learning and memory than men in both the NHW and Hispanic cohorts, which is consistent with prior literature; however, Hispanic women living in a more disadvantaged area had even worse cognition than Hispanic women in less disadvantaged areas, which was not evident for men. There were few associations between ND and blood biomarkers for NHWs, but Hispanic individuals in more disadvantaged areas were found to have higher concentrations of amyloid and neurodegeneration markers. For NHW and NHB participants, living in more disadvantaged areas was predictive of increased symptoms of depression. We also found evidence suggesting that higher levels of contextual ND are predictive of increased chronic stress, though this differed as a function of an individual’s race/ethnicity. Conclusions: Community context needs to be considered in aging research. For Hispanic and NHW older adults, there are important associations with age and sex, cognition, biomarkers, and mental health. For Hispanic older adults, these individual factors intersect the community context, such that living in a disadvantaged area is associated with worse outcomes. This likely reflects structural inequities exacerbating the health disparities faced by racial and ethnic minorities, which are amenable to public policy interventions. Implications for future research and clinical care are discussed.

Custom Content

Poster Session 11 Program Schedule

02/17/2024
10:45 am - 12:00 pm
Room: Shubert Complex (Posters 1-60)

Poster Session 11: Cultural Neuropsychology | Education/Training | Professional Practice Issues

Final Abstract #6

Poster Symposium: Summary

Intersecting Determinants of Health: The Influences of Community, sex, race, and Ethnicity in Aging Outcomes, a Health & Aging Brain Study – Health Disparities project

Category: Dementia (Alzheimer's Disease)

Keyword 1: diversity
Keyword 2: dementia - Alzheimer's disease
Keyword 3: minority issues

Summary Abstract:

Objective: Demographic factors including age, sex, race, and ethnicity are commonly considered in clinical practice and aging research, given their associations with Alzheimer’s disease (AD) risk and outcomes. There is an emerging literature associating contextual-level social determinants of health (SDoH) such as neighborhood disadvantage (ND), which is strongly linked to structural and systemic inequities, with health and aging outcomes. However, relatively little is known about these influences on brain aging, and even less is known about how they intersect with sex, race, and ethnicity. As healthcare moves into the era of personalized medicine, understanding how these varying dimensions of diversity intersect to influence one’s aging trajectory is a major area of interest. In this symposium, we present a series of projects that specifically address several of these knowledge gaps.

Participants and Methods: Data presented are from the Health & Aging Brain Study – Health Disparities (HABS-HD), the largest prospective study focused on the study of aging in the 3 largest racial and ethnic groups in the United States, non-Hispanic Blacks (NHB), Hispanics, and non-Hispanic Whites (NHW). Community-dwelling adults over the age of 50 are recruited into HABS-HD using community-based participatory research methods and followed longitudinally. Standard protocols include clinical exams with cognitive testing, blood draw for clinical labs and AD biomarkers, and brain imaging collected every 24 months. Neighborhood disadvantage is assessed using the Area Deprivation Index (ADI) based on the participant’s current address at the time of visit. Baseline data were used in all analyses.

Results: Across projects, Hispanic individuals were more likely to reside in disadvantaged areas compared to NHWs. We first found that NHW and Hispanic individuals aging in more disadvantaged areas had worse cognition compared to those in less disadvantaged areas, which was more pronounced in Hispanic individuals. We also found that women showed better verbal learning and memory than men in both the NHW and Hispanic cohorts, which is consistent with prior literature; however, Hispanic women living in a more disadvantaged area had even worse cognition than Hispanic women in less disadvantaged areas, which was not evident for men. There were few associations between ND and blood biomarkers for NHWs, but Hispanic individuals in more disadvantaged areas were found to have higher concentrations of amyloid and neurodegeneration markers. For NHW and NHB participants, living in more disadvantaged areas was predictive of increased symptoms of depression. We also found evidence suggesting that higher levels of contextual ND are predictive of increased chronic stress, though this differed as a function of an individual’s race/ethnicity.

Conclusions: Community context needs to be considered in aging research. For Hispanic and NHW older adults, there are important associations with age and sex, cognition, biomarkers, and mental health. For Hispanic older adults, these individual factors intersect the community context, such that living in a disadvantaged area is associated with worse outcomes. This likely reflects structural inequities exacerbating the health disparities faced by racial and ethnic minorities, which are amenable to public policy interventions. Implications for future research and clinical care are discussed.