AD Related Dementias – Specific
Test early mechanistic pathways of multiple etiologies that may account for AD/ADRD health disparities and scientifically move forward potential opportunities for precision medicine.
- Initiate or leverage a longitudinal community-based cohort study of incident cognitive impairment in populations that experience heath disparities burdens in dementia. This research is to be designed to assess the interactions of social, environmental, and molecular mechanisms. Biospecimen and clinical data collection should be embedded in the study design to facilitate wide sharing for research. Studies should incorporate cutting-edge imaging, fluid-based and other biomarkers, autopsy (when possible), and other biospecimens for mechanism-oriented research.
- Support at least two studies investigating whether changes in risk factors for cognitive impairment and dementia occur over the life course in diverse populations. Identify critical periods of life and critical lifestyle and other parameters with respect to cognitive impairment and dementia prevention.
- Support at least two studies investigating whether the prevalence and interaction of AD/ADRD risk factors (e.g., genetic, vascular, behavioral, environmental, or social risks), and their impact on outcomes, differs across populations, including populations that experience health disparities in dementia. Use this information to estimate the highest impact intervention targets (i.e., population burden associated with each risk factor) toward the development of population-specific informed precision medicine for dementia.
- Facilitate data and biospecimen availability for future research.
Summary of Key Accomplishments
Recent NIH-funded research studies indicate that one of the highest impact intervention targets for population-level dementia risk, and especially for dementia risk in Black, Hispanic, and rural populations, is elevated mid-life blood pressure (see citation below). NIH continues to study risk factors for dementia and cognitive impairment in several studies, including the VCID and Stroke in a Bi-racial National Cohort (REGARDS) study, which follows more than 6000 participants aged 75+ and is ideal to provide insights about racial and geographic disparities in dementia and stroke risk as well as the Atherosclerosis Risk in Communities (ARIC), is designed to investigate the causes of atherosclerosis and its clinical outcomes including dementia, and variation in cardiovascular risk factors, medical care, and disease by race, gender, location, and date.
Citation: Levine DA, et al. Association Between Blood Pressure and Later-Life Cognition Among Black and White Individuals. JAMA Neurol. 2020 Jul 1;77(7):810-819.
This information is current as of July 2022.
- Research Implementation Area
- AD Related Dementias - Specific
- In Progress
- PAR-15-349: Health Disparities and Alzheimer’s Disease (R01)
- PAR-15-350: Emerging Directions for Addressing Health Disparities in Alzheimer's Disease (R03)
- RFA-NS-19-012: Post-Stroke Vascular Contributions to Cognitive Impairment and Dementia (VCID) in the United States Including in Health Disparities Populations (U19)
- RFA-NS-20-013: White Matter Disease Etiology of Dementia in the U.S. Including in Health Disparities Populations
Research Programs and Resources
- VCID and Stroke in a Bi-racial National Cohort (REGARDS)
- Health Disparities and Alzheimer’s Disease (R01)
- Emerging Directions for Addressing Health Disparities in Alzheimer's Disease (R03)
- Post-Stroke Vascular Contributions to Cognitive Impairment and Dementia (VCID) in the United States Including in Health Disparities Populations (U19)
- Diverse VCID: White Matter Lesion Etiology of Dementia in Diverse Populations
- Determinants of Incident Stroke Cognitive Outcomes and Vascular Effects on Recovery (DISCOVERY)
- 24-hour Activity Cycles to Optimize Cognitive Resilience to Alzheimer's Disease in African Americans: The Jackson Heart Study