Race, community disadvantage, and cognitive decline: Findings from KHANDLE and STAR

Rachel L. Peterson; Rebecca Pejak; Kristen M. George; Paola Gilsanz; Michelle Ko; Oanh L. Meyer; Elizabeth Rose Mayeda; Amy Kind; Rachel A. Whitmer

doi:10.1002/alz.13511

Race, community disadvantage, and cognitive decline: Findings from KHANDLE and STAR

Rachel L. Peterson
, Rebecca Pejak
, Kristen M. George
, Paola Gilsanz
, Michelle Ko
, Oanh L. Meyer
, Elizabeth Rose Mayeda
, Amy Kind
, Rachel A. Whitmer

School of Public and Community Health Sciences

University of Montana
University of California at Davis
Kaiser Permanente
University of California at Los Angeles
University of Wisconsin-Madison

Research output: Contribution to journal › Article › peer-review

5 Scopus citations

Abstract

INTRODUCTION: Community disadvantage is associated with late-life cognition. Few studies examine its contribution to racial disparities in cognition/cognitive change. METHODS: Inverse probability weighted models estimated expected mean differences in cognition/cognitive change attributed to residing in less advantaged communities, defined as cohort top quintile of Area Deprivation Indices (ADI): childhood 66–100; adulthood ADI 5-99). Interactions by race tested. RESULTS: More Black participants resided in less advantaged communities. Semantic memory would be lower if all participants had resided in less advantaged childhood (b = -0.16, 95% confidence interval [CI] = -0.30, -0.03) or adulthood (b = -0.14, 95% CI = -0.22, -0.04) communities. Race interactions indicated that, among Black participants, less advantaged childhood communities were associated with higher verbal episodic memory (interaction p-value = 0.007) and less advantaged adulthood communities were associated with lower semantic memory (interaction p-value = 0.002). DISCUSSION: Examining racial differences in levels of community advantage and late-life cognitive decline is a critical step toward unpacking community effects on cognitive disparities.

Original language	English
Pages (from-to)	904-913
Number of pages	10
Journal	Alzheimer's and Dementia
Volume	20
Issue number	2
Early online date	Oct 10 2023
DOIs	https://doi.org/10.1002/alz.13511
State	Published - 2023

Funding

The authors appreciate the detailed work provided by Kevin Zhou, KPNC Data Analyst, in geocoding the multiple historical addresses of STAR and KHANDLE cohort participants used in this analysis. Dr Peterson and Ms Pejak are supported by NIH/NIA 4R00AG073457‐02. Dr George is supported by NIH/NIA R01AG052132, R01AG056519, and RF1AG050782 and California Department of Public Health RFA 20‐10079. Dr Gilsanz is supported by NIH/NIA R01AG052132. Dr Ko is supported by NIH/NIA R01AG067525‐03. Dr Mayeda is supported by NIH/NIA R01AG052132 and R01AG074359. Dr Kind is supported by NIH/NIA RF1AG057784; R01AG070883 and 1R01MD010243. Dr Whitmer is supported by NIH/NIA R01AG052132 and 7RF1AG050782‐02. The authors appreciate the detailed work provided by Kevin Zhou, KPNC Data Analyst, in geocoding the multiple historical addresses of STAR and KHANDLE cohort participants used in this analysis. Dr Peterson and Ms Pejak are supported by NIH/NIA 4R00AG073457-02. Dr George is supported by NIH/NIA R01AG052132, R01AG056519, and RF1AG050782 and California Department of Public Health RFA 20-10079. Dr Gilsanz is supported by NIH/NIA R01AG052132. Dr Ko is supported by NIH/NIA R01AG067525-03. Dr Mayeda is supported by NIH/NIA R01AG052132 and R01AG074359. Dr Kind is supported by NIH/NIA RF1AG057784; R01AG070883 and 1R01MD010243. Dr Whitmer is supported by NIH/NIA R01AG052132 and 7RF1AG050782-02. Rachel L. Peterson, Funding: NIH/NIA 4R00AG073457-02 (PI: Peterson). Rebecca Pejak, Funding: NIH/NIA 4R00AG073457-02 (PI: Peterson). Kristen M. George, Funding: NIH/NIA R01AG052132 (Whitmer, Glymour, Gilsanz, Mayeda); R01AG056519 (Whitmer, Gilsanz, Corrada); RF1AG050782 (Whitmer); California Department of Public Health RFA 20-10079 (Nosheny, Mayeda, George). Paola Gilsanz, Funding: NIH/NIA R01AG052132 (PI: Whitmer, Gilsanz, Glymour, Mayeda). Michelle Ko, Funding: NIH/NIA R01AG067525-03 (PI: Ko). Oanh L. Meyer, Funding: NIH/NIA R01AG067541 (PI: Meyer). Elizabeth Rose Mayeda, Funding: NIH/NIA R01AG052132 (PI: Whitmer, Gilsanz, Glymour, Mayeda), R01AG074359 (PI: Casey, Mayeda). Amy Kind, Funding: NIH/NIA RF1AG057784 (Kind, Bendlin); 1R01MD010243 (PI: Kind); R01AG070883 (Kind, Bendlin). Rachel A. Whitmer, Funding: NIH/NIA R01AG052132 (PI: Whitmer, Gilsanz, Glymour, Mayeda); 7RF1AG050782-02 (PI: Whitmer).

Funder number
R01AG056519, RF1AG050782, R01AG052132, 4R00AG073457-02
RF1AG057784, RFA 20‐10079, R01AG067525‐03, R01AG074359, 1R01MD010243, 7RF1AG050782‐02, R01AG070883

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

health disparities
social determinants
social epidemiology
structural racism

Access to Document

10.1002/alz.13511

Cite this

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title = "Race, community disadvantage, and cognitive decline: Findings from KHANDLE and STAR",

abstract = "INTRODUCTION: Community disadvantage is associated with late-life cognition. Few studies examine its contribution to racial disparities in cognition/cognitive change. METHODS: Inverse probability weighted models estimated expected mean differences in cognition/cognitive change attributed to residing in less advantaged communities, defined as cohort top quintile of Area Deprivation Indices (ADI): childhood 66–100; adulthood ADI 5-99). Interactions by race tested. RESULTS: More Black participants resided in less advantaged communities. Semantic memory would be lower if all participants had resided in less advantaged childhood (b = -0.16, 95\% confidence interval [CI] = -0.30, -0.03) or adulthood (b = -0.14, 95\% CI = -0.22, -0.04) communities. Race interactions indicated that, among Black participants, less advantaged childhood communities were associated with higher verbal episodic memory (interaction p-value = 0.007) and less advantaged adulthood communities were associated with lower semantic memory (interaction p-value = 0.002). DISCUSSION: Examining racial differences in levels of community advantage and late-life cognitive decline is a critical step toward unpacking community effects on cognitive disparities.",

keywords = "health disparities, social determinants, social epidemiology, structural racism",

author = "Peterson, \{Rachel L.\} and Rebecca Pejak and George, \{Kristen M.\} and Paola Gilsanz and Michelle Ko and Meyer, \{Oanh L.\} and Mayeda, \{Elizabeth Rose\} and Amy Kind and Whitmer, \{Rachel A.\}",

note = "{\textcopyright} 2023 The Authors. Alzheimer's \& Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.",

year = "2023",

doi = "10.1002/alz.13511",

language = "English",

volume = "20",

pages = "904--913",

journal = "Alzheimer's and Dementia",

issn = "1552-5260",

publisher = "John Wiley and Sons Inc.",

number = "2",

}

TY - JOUR

T1 - Race, community disadvantage, and cognitive decline

T2 - Findings from KHANDLE and STAR

AU - Peterson, Rachel L.

AU - Pejak, Rebecca

AU - George, Kristen M.

AU - Gilsanz, Paola

AU - Ko, Michelle

AU - Meyer, Oanh L.

AU - Mayeda, Elizabeth Rose

AU - Kind, Amy

AU - Whitmer, Rachel A.

PY - 2023

Y1 - 2023

N2 - INTRODUCTION: Community disadvantage is associated with late-life cognition. Few studies examine its contribution to racial disparities in cognition/cognitive change. METHODS: Inverse probability weighted models estimated expected mean differences in cognition/cognitive change attributed to residing in less advantaged communities, defined as cohort top quintile of Area Deprivation Indices (ADI): childhood 66–100; adulthood ADI 5-99). Interactions by race tested. RESULTS: More Black participants resided in less advantaged communities. Semantic memory would be lower if all participants had resided in less advantaged childhood (b = -0.16, 95% confidence interval [CI] = -0.30, -0.03) or adulthood (b = -0.14, 95% CI = -0.22, -0.04) communities. Race interactions indicated that, among Black participants, less advantaged childhood communities were associated with higher verbal episodic memory (interaction p-value = 0.007) and less advantaged adulthood communities were associated with lower semantic memory (interaction p-value = 0.002). DISCUSSION: Examining racial differences in levels of community advantage and late-life cognitive decline is a critical step toward unpacking community effects on cognitive disparities.

AB - INTRODUCTION: Community disadvantage is associated with late-life cognition. Few studies examine its contribution to racial disparities in cognition/cognitive change. METHODS: Inverse probability weighted models estimated expected mean differences in cognition/cognitive change attributed to residing in less advantaged communities, defined as cohort top quintile of Area Deprivation Indices (ADI): childhood 66–100; adulthood ADI 5-99). Interactions by race tested. RESULTS: More Black participants resided in less advantaged communities. Semantic memory would be lower if all participants had resided in less advantaged childhood (b = -0.16, 95% confidence interval [CI] = -0.30, -0.03) or adulthood (b = -0.14, 95% CI = -0.22, -0.04) communities. Race interactions indicated that, among Black participants, less advantaged childhood communities were associated with higher verbal episodic memory (interaction p-value = 0.007) and less advantaged adulthood communities were associated with lower semantic memory (interaction p-value = 0.002). DISCUSSION: Examining racial differences in levels of community advantage and late-life cognitive decline is a critical step toward unpacking community effects on cognitive disparities.

KW - health disparities

KW - social determinants

KW - social epidemiology

KW - structural racism

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SN - 1552-5260

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JO - Alzheimer's and Dementia

JF - Alzheimer's and Dementia

IS - 2

ER -

Race, community disadvantage, and cognitive decline: Findings from KHANDLE and STAR

Abstract

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UN SDGs

Keywords

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