Byrd DeAnnah R, Martin Danielle A, Joseph Rodney P
Edson College of Nursing and Health Innovation, Arizona State University, Health North, Suite 301, 550 N 3rd Street, Phoenix, AZ 85004, USA.
Center for Innovation in Healthy and Resilient Aging, Edson College of Nursing and Health Innovation, Arizona State University, 500 N 3rd St., Phoenix, AZ 85004, USA.
Curr Epidemiol Rep. 2023 Dec;10(4):252-263. doi: 10.1007/s40471-023-00337-9. Epub 2023 Nov 14.
This narrative review summarizes environmental, sociocultural, behavioral, and biological factors associated with cognitive decline and dementia in Black Americans.
Variations in environmental factors (education, toxins) contribute to poor cognition in Blacks. Historical context, early-life educational experiences, and environmental exposures should be considered for addressing late-life cognitive disparities. Sociocultural (stress, discrimination, social networks, social activity, loneliness) and behavioral (depression, coping, health behaviors) factors can have positive and negative implications for cognitive aging. Given these factors are not consistently shown to play a role in maintaining cognition in Blacks, further examination is needed. Cardiometabolic conditions increase the risk of cognitive issues and are more common in Blacks; thus, examination of biological mechanisms (inflammation, vascular changes, etc.) warrants further study.
Future studies should explore the impact of education and segregation and identify mechanisms linking stress and discrimination to cognitive outcomes. Further, culturally tailored programs focused on preventative behaviors are needed to enhance health outcomes and reduce disparities.
本叙述性综述总结了与美国黑人认知衰退和痴呆相关的环境、社会文化、行为和生物学因素。
环境因素（教育、毒素）的差异导致黑人认知能力较差。在解决晚年认知差异问题时，应考虑历史背景、早年教育经历和环境暴露情况。社会文化因素（压力、歧视、社交网络、社交活动、孤独感）和行为因素（抑郁、应对方式、健康行为）对认知老化可能产生积极和消极影响。鉴于这些因素在维持黑人认知方面的作用并不一致，需要进一步研究。心脏代谢疾病会增加认知问题的风险，且在黑人中更为常见；因此，对生物学机制（炎症、血管变化等）的研究值得进一步深入。
未来的研究应探讨教育和种族隔离的影响，并确定将压力和歧视与认知结果联系起来的机制。此外，需要有针对预防行为的文化定制项目，以改善健康状况并减少差异。
