Racial/ethnic minority adults are at higher risk for Alzheimer’s disease and related dementias (ADRD). Moreover, minority adults not only are exposed to more stressful situations in their daily lives but they also have fewer resources to manage these situations in healthy ways. Limited resources among these adults may lead to impaired physiologic stress responses (i.e., stress reactivity), specifically chronic activation of the physiologic stress response systems, including the sympathetic nervous system and the hypothalamic-pituitary-adrenocortical (HPA) axis. Our understanding of the impact of stress reactivity on ADRD risk comes from animal studies and experiments in humans using laboratory stressors. This is a major limitation because laboratory stressors cannot capture the variety, severity, or duration of stressors that individuals face in their daily lives. Thus, there remains a need to more rigorously evaluate relationships of stress reactivity with ADRD risk in natural settings. We propose to fill this critical gap in the literature by adding personalized (person-level) indicators of stress reactivity and several rigorous measures of cognitive function to our NIA-funded multi-ethnic ecological momentary assessment (EMA) study (R01AG062180) of 510 Chicago area adults aged 40-64 years. We will leverage planned EMA measurements of stressful experiences and negative affect (emotions) by adding continuous ECG monitoring and cognitive function tests in a subset of 350 participants. We will use data collected over a 14-day study period to develop personalized measures of autonomic and affective stress reactivity. We will then examine whether these measures of stress reactivity are associated with cognitive function. Finally, we will test whether racial/ethnic differences in cognitive function are mediated by differences in autonomic and affective stress reactivity. Recommendation 3, Priority 2 of the 2019 ADRD Summit Draft Recommendations is to test mechanistic pathways that may account for AD/ADRD disparities including psychosocial factors like stress. Thus, our proposed study in a multi-ethnic sample will lay the foundation for a research program focused on elucidating the contributions of stress reactivity to disparities in ADRD risk.
|Effective start/end date||9/1/20 → 8/31/22|
- National Institute on Aging (1R21AG069435-01)