Introduction: We examined whether educational attainment differentially contributes to cognitive reserve (CR) across race/ethnicity. Methods: A total of 1553 non-Hispanic Whites (Whites), non-Hispanic Blacks (Blacks), and Hispanics in the Washington Heights-Inwood Columbia Aging Project (WHICAP) completed structural magnetic resonance imaging. Mixture growth curve modeling was used to examine whether the effect of brain integrity indicators (hippocampal 70
Introduction
The projected growth of Alzheimer's disease (AD) and AD‐related dementia (ADRD) cases by midcentury has expanded the research field and impelled new lines of inquiry into structural and social determinants of health (S/SDOH) as fundamental drivers of disparities in AD/ADRD.
Methods
In this review, we employ Bronfenbrenner's ecological systems theory as a framework to posit how S/SDOH impact AD/ADRD risk and outcomes.
Results
Bronfenbrenner defined the “macrosystem” as the realm of power (structural) systems that drive S/SDOH and that are the root cause of health disparities. These root causes have been discussed little to date in relation to AD/ADRD, and thus, macrosystem influences, such as racism, classism, sexism, and homophobia, are the emphasis in this paper.
Discussion
Under Bronfenbrenner's macrosystem framework, we highlight key quantitative and qualitative studies linking S/SDOH with AD/ADRD, identify scientific gaps in the literature, and propose guidance for future research.
Highlights
Ecological systems theory links structural/social determinants to AD/ADRD.
Structural/social determinants accrue and interact over the life course to impact AD/ADRD.
Macrosystem is made up of societal norms, beliefs, values, and practices (e.g., laws).
Most macro‐level determinants have been understudied in the AD/ADRD literature.
The Strong Black Woman (SBW) schema has been consistently linked to negative mental health outcomes among Black women. However, few have begun to explicate the mechanisms by which the endorsement of the SBW schema may influence mental health outcomes. Accordingly, the current study examined coping styles (social support, disengagement, spirituality, and problem-oriented/engagement) as mediators in the association between endorsement of the SBW schema and depressive symptoms in a sample of Black women. Data from 240 Black women ( Mage = 22.0, SD = 4.0 years) were collected assessing SBW schema endorsement, coping styles, and depressive symptoms. Parallel multiple mediation analysis was conducted using PROCESS Macro. Of the four coping styles examined, disengagement coping partially mediated the association between greater endorsement of the SBW schema and greater depressive symptoms. Study findings add depth to our understanding of the association between the SBW schema and mental health outcomes and lend themselves to research and clinical implications.
TBI may have an enduring effect on the orienting system at both neural and behavioural levels. Assessment of attention in chronic TBI can be improved by the integration of hemispheric findings that suggest disproportionate vulnerability in leftward orienting. Results may enhance clinical sensitivity to detection of subtle signs of neglect.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.