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Psychological, environmental, and biological factors linked to cognitive decline in Black older adults: a multi‐level approach from the Minority Aging Research Study (MARS)

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Udgivet i:Alzheimer's & Dementia vol. 21 (Dec 1, 2025)
Hovedforfatter: Souza‐Talarico, Juliana Nery
Andre forfattere: Capuano, Ana W., Barnes, Lisa L.
Udgivet:
John Wiley & Sons, Inc.
Fag:
Aging
Episodic memory
Hormones
Semantic memory
Psychological aspects
Social factors
Memory
Research
Older people
Housing
African Americans
Glucose
Cognition
Metabolism
Environmental aspects
Vulnerability
Community
Cognition & reasoning
Discrimination
Black white relations
Cognitive impairment
Black people
Biology
Biological markers
Minority groups
Semantic processing
Testosterone
Sex education
Short term memory
Alzheimer's disease
Semantics
Memory tests
Immunology
Cortisol
Medicine
Body weight
Adults
Cognitive ability
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Resumen:Background Black Americans are twice as likely to develop Alzheimer's Disease and Related Dementias (ADRD) compared to White individuals, with psychological and social factors contributing to this disparity. The biological mechanisms linking these factors to cognitive decline are still under investigation. A multi‐domain approach across individual, interpersonal, and community levels is necessary to understand this complex relationship. This study aimed to determine the associations between psychological, environmental, and biological factors linked to cognitive decline in older Black adults. Methods Longitudinal data from 118 Black Americans aged 65 and older from the Minority Aging Research Study (MARS) were analyzed. The biological factors at the individual level included blood‐based neuroendocrine (cortisol, DHEA‐S, testosterone, IGF‐1), immunologic (IL‐10, IL‐1ra, IL‐6, CRP, TNF‐α), and metabolic (LDL‐C, HbA1C, BMI, GFR) markers. Discrimination, a psychological factor at the interpersonal level, was measured using the Everyday Discrimination Scale (EDS). The Social Vulnerability Index, a geospatial data comprising socioeconomic, housing and transportation, minority groups and language, and household and disability, assessed the environmental factors at the community level. Cognitive decline, the primary outcome, was evaluated using annual performance on global cognition, processing speed, working, semantic, and episodic memory tests since 2004. Ordinal models and a stepwise approach identified markers associated with discrimination, social vulnerability, and cognition. Results Controlling for sex, age, and education, high EDS was associated with neuroendocrine (cortisol p = .007; IGF‐1 p = .026; testosterone p = .009) and immunological markers (IL‐1ra p = .006; TNF‐α p = .044), while high SVI was linked to neuroendocrine (cortisol p = .0010; IGF1 p = .018), and metabolic markers (LDL p = .005, BMI p = .044). In the final models, EDS (p = .039), SVI (p = .019), neuroendocrine (IGF1 p = .029, DHEAS p = .022), immunological (CRP p = .016; IL‐1ra p = .05; TNF‐α (p = .030) and metabolic (HbA1C p = .018 BMI p = .03, glucose p = .038, GRF1 p = .029) markers were associated with decline in global cognition, working memory processing speed and semantic memory. Conclusion These findings suggest that psychological, environmental, and biological factors at the individual, interpersonal, and community levels may synergistically contribute to cognitive decline. Our findings inform future research incorporating ADRD biomarkers to improve early prediction of ADRD and enable timely prevention through precise medicine.
ISSN:1552-5260
1552-5279
DOI:10.1002/alz70858_107802
Fuente:Consumer Health Database