Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA.
J Gerontol A Biol Sci Med Sci. 2022 Feb 3;77(2):357-364. doi: 10.1093/gerona/glab099.
Racial disparities in cognitive function are well documented, but factors driving these disparities remain underexplored. This study aims to quantify the extent to which cumulative stress exposures across the life course explain Black-White disparities in executive function and episodic memory in middle-aged and older adults.
Data were drawn from the 2004-2006 wave of the Midlife Development in the United States Study (MIDUS 2) and the MIDUS Refresher study (N = 5,947; 5,262 White and 685 Black). Cumulative stress exposures were assessed by 10 stressor domains (ie, childhood stress, stressful life events in adulthood, financial stress, work psychological stress, work physical stress, work-family conflicts, neighborhood disorder, relationship stress, perceived inequality, and perceived discrimination). Cognitive function was assessed using the Brief Test of Adult Cognition by Telephone. Marginal structural models were used to quantify the proportion of the effect of race/ethnicity status on cognitive function mediated through cumulative stress exposures.
After adjusting for age, sex, and sample, on average, Black participants had lower levels of executive function (difference: -0.83 SD units, 95% CI: -0.91, -0.75) and episodic memory (difference: -0.53 SD units, 95% CI: -0.60, -0.45) scores than White participants. Cumulative stress exposures accounted for 8.4% of the disparity in executive function and 13.2% of the disparity in episodic memory.
Cumulative stress exposures across the life course explained modest proportions of Black-White disparities in cognitive function in this large cross-sectional study.
认知功能方面的种族差异有大量记载，但导致这些差异的因素仍未得到充分探索。本研究旨在量化整个生命历程中累积的应激暴露在多大程度上解释了中年和老年人执行功能和情景记忆方面的黑-白差异。
数据来自 2004-2006 年美国中期发展研究（MIDUS 2）和 MIDUS 复习研究（N=5947；5262 名白人和 685 名黑人）。通过 10 个应激源领域（即儿童期应激、成年期生活应激事件、经济应激、工作心理应激、工作体力应激、工作-家庭冲突、邻里混乱、关系应激、不平等感知和歧视感知）评估累积应激暴露。使用电话式成人认知简短测试评估认知功能。边际结构模型用于量化种族/民族地位对认知功能的影响通过累积应激暴露的中介作用的比例。
在调整年龄、性别和样本后，平均而言，黑人参与者的执行功能（差异：-0.83 标准差单位，95%置信区间：-0.91，-0.75）和情景记忆（差异：-0.53 标准差单位，95%置信区间：-0.60，-0.45）得分低于白人参与者。累积应激暴露解释了执行功能差异的 8.4%和情景记忆差异的 13.2%。
在这项大型横断面研究中，整个生命历程中的累积应激暴露解释了认知功能方面的黑-白差异的适度比例。
