Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Johns Hopkins Alzheimer's Disease Resource Center for Minority Aging Research, Johns Hopkins University, Baltimore, MD, USA.
J Aging Health. 2023 Oct;35(9_suppl):40S-50S. doi: 10.1177/08982643231203755.
We examined whether social determinants of health (SDoH) are associated with Alzheimer's disease and related dementias (ADRD) risk and the effects of cognitive training over a 20-year follow-up period. Data were obtained from 1605 participants in ACTIVE. SDoH measures were created using baseline data at the individual and neighborhood level. Incident ADRD was defined using administrative claims data (1999-2019). Cause-specific hazard models estimated associations between SDoH and claims-based diagnosed ADRD. Higher scores on neighborhood and built environment were associated with lower ADRD risk. Trained participants obtained a greater degree of protection from ADRD when they had higher scores for SDoH domains associated with health care and education access. However, there were fewer significant SDoH moderation effects on cognitive training than expected. Future work should continue to explore culturally tailored cognitive training interventions to reduce ADRD risk associated with SDoH that disproportionately affects racially diverse aging populations.
我们研究了社会决定因素（SDoH）是否与阿尔茨海默病和相关痴呆症（ADRD）风险相关，以及认知训练在 20 年的随访期间的效果。数据来自 ACTIVE 的 1605 名参与者。使用个体和社区层面的基线数据创建 SDoH 测量。通过行政索赔数据（1999-2019 年）定义了 ADRD 的发病情况。特定原因的危险模型估计了 SDoH 与基于索赔的诊断 ADRD 之间的关联。社区和建筑环境的得分越高，ADRD 风险越低。接受过培训的参与者在与医疗保健和教育机会相关的 SDoH 领域得分较高时，获得 ADRD 保护的程度更高。但是，认知训练的 SDoH 调节作用比预期的要少。未来的工作应继续探索针对特定文化的认知训练干预措施，以减少与社会决定因素相关的 ADRD 风险，这些风险不成比例地影响着不同种族的老龄化人口。
