“…Lower socioeconomic status, chronic health conditions and decreased health literacy (Verney et al, 2019), worse early-life education quality (Sisco et al, 2015) and fewer years of education (Weuve et al, 2018), perceived discrimination (Zahodne et al, 2017), geographical location (Liu et al, 2015), and genetic variations other than APOEε4 (Lee et al, 2007;Logue et al, 2014;Mez et al, 2017a;Yu et al, 2017a,b) all contribute to increased vulnerability to cognitive decline among Black participants (Zahodne et al, 2017). These variables may have increased salience in American football players and thus have important clinical implications (Asken et al, 2016(Asken et al, , 2017Allison et al, 2018). Nuanced approaches (Galea et al, 2010) that model the multilevel interactions among social, environmental, genetic, and biological variables will elucidate racial heterogeneity associated with brain aging (in all settings).…”