Stressful Life Events and Racial Disparities in Cognition Among Middle-Aged and Older Adults

Abstract

Background: It is well-documented that African Americans have elevated risk for cognitive impairment and dementia in late life, but reasons for the racial disparities remain unknown. Stress processes have been linked to premature age-related morbidity, including Alzheimer's and related dementias (ADRD), and plausibly contribute to social disparities in cognitive aging. Objective: We examined the relationship between stressful life events and cognitive decline among African American and White participants enrolled in the Wisconsin Registry for Alzheimer's Prevention (WRAP). Methods: Linear mixed models including demographic, literacy, and health-related covariates were used to estimate (1) relationships between a life event index score and decline in cognitive test performance in two domains of executive function (Speed & Flexibility, Working Memory) and one domain of episodic memory (Verbal Learning & Memory) among 1,241 WRAP enrollees, stratified by race, and (2) contributions of stressful life events to racial differences in cognition within the full sample.

Racial Differences in Dietary Relations to Cognitive Decline and Alzheimer’s Disease Risk: Do We Know Enough?

“…Various social and demographic factors that have been studied for health disparities in Alzheimer’s dementia include educational attainment ( Weuve et al, 2018 ), bilingualism ( Lamar et al, 2019 ), neighborhood greenness ( Brown et al, 2018 ), and stressful life events ( Zuelsdorff et al, 2020 ). Similar social and economic aspects may also affect the diet quality by race, including education and income ( Raffensperger et al, 2010 ), health literacy ( Kuczmarski et al, 2016 ), food prices and diet costs ( Townsend et al, 2009 ) and neighborhood grocery store availability ( Powell et al, 2007 ; Bower et al, 2014 ).…”

Vascular contributions to cognitive impairment and dementia (VCID): A report from the 2018 National Heart, Lung, and Blood Institute and National Institute of Neurological Disorders and Stroke Workshop

“…These comorbidities and risk factors include but are not limited to: cardio- 7 and cerebrovascular disease; 8 metabolic disorders of lipid and glucose metabolism including diabetes and obesity; 9-11 immune dysfunction; 12,13 and behavioral risk factors for many dementia comorbidities such as smoking, dietary behavior, physical inactivity, and possibly stress. [14][15][16] The racial/ethnic and socioeconomic health disparities in VCID have been described yet are not well understood, and often are consistent with health disparity patterns in other age-related comorbidities. We expect that promoting a fuller and deeper understanding of the mechanisms of VCID at molecular, cellular, and systems levels across the wide spectrum of pathologies, chronic systemic comorbidities, and other risk factors may lead to potential prevention and treatment strategies to decrease the burden of dementia.…”

“…Chronic systemic comorbidities and risk factors are also associated with deleterious cognitive outcomes. These comorbidities and risk factors include but are not limited to: cardio‐ 7 and cerebrovascular disease; 8 metabolic disorders of lipid and glucose metabolism including diabetes and obesity; 9‐11 immune dysfunction; 12,13 and behavioral risk factors for many dementia comorbidities such as smoking, dietary behavior, physical inactivity, and possibly stress 14‐16 . The racial/ethnic and socioeconomic health disparities in VCID have been described yet are not well understood, and often are consistent with health disparity patterns in other age‐related comorbidities.…”

Can healthy lifestyle reduce disease progression of Alzheimer’s during a global pandemic of COVID-19?

“…As a result, people with depression have a higher risk for Alzheimer’s. According to a research study done at the University of Wisconsin, African Americans who reported more stressful events in their lives, such as living in a disadvantaged neighborhood, bankruptcy, alcoholism, and educational complications, were linked with low cognitive function ( Zuelsdorff et al, 2020 ). Another study done at UCSF found a higher rate of dementia in African American participants living in states with high infant mortality.…”