The role of adverse community-level policing exposure on disparities in Alzheimer's disease related dementias and deleterious multidimensional aging

PROJECT SUMMARY / ABSTRACT To reduce racial disparities in Alzheimer’s disease related dementias (ADRD) for US Black and Latinx/a/o older adults, it is crucial to examine key structural determinants of health that occur across the life course, like structural racism. However, limited research explores a prominent component of structural racism, adverse community-level policing (CLP), that Black and Latinx/a/o older adults have consistently encountered across the life course from historical police-sanctioned lynchings during early life, to police-involved killings, arrests, and incarcerations of Black and Latinx/a/o persons during midlife. The National Institute of Aging’s Health Disparities Research Framework identifies political factors as a priority area of research on aging, yet minimal research exists on this determinant. In this study, I will fill major gaps in understanding how adverse CLP exposure increases risk for incident dementia, cognitive decline, accelerated aging, and poor psychological health for Black and Latinx/a/o older adults. The specific research aims are to examine the following among Black and Latinx/a/o participants in the Health and Retirement Study: Aim 1) Estimate the association between midlife adverse CLP exposure with depressive symptoms and subjective cognitive function over a 20-year period starting from the onset of the Violent Crime Control and Law Enforcement Act of 1994. Aim 2) Explore the relationship between early life adverse CLP exposure with incident dementia and accelerated biological age after 50. Aim 3) Compare the effects of early and midlife adverse CLP exposure on objectively measured memory performance in late life. These aims lay the groundwork for a R01 application exploring interventions to the pathway from adverse CLP exposure to ADRD. Dr. Paris Adkins-Jackson’s long-term career goal is to become an independent investigator that leads research that explicates the role of structural determinants like structural racism on ADRD and multidimensional aging for historically marginalized groups like Black and Latinx/a/o communities. She seeks a K01 Mentored Research Scientist Development Award to obtain critical content area knowledge on ADRD, cognitive function, and biological aging to complement her expertise in structural racism and psychological health, which will lead to an independently funded research program. Her career development plan includes didactic courses and mentored research in ADRD, cognitive function, and biological aging, and leadership in ADRD disparities research. This training will occur in the rich environment at Columbia University, including the Mailman School of Public Health and the Gertrude H. Sergievsky Center at Columbia University Irving Medical Center. Dr. Adkins-Jackson will receive guidance from an experienced team with a strong track record of mentoring and funding in ADRD, cognitive function, biological aging, and adverse CLP exposure—many of whom wrote seminal literature on structural racism and ADRD disparities. Building on such work, this study determines the magnitude of a modifiable factor that may lead to neurodegeneration and harmful aging.