Social Determinants of Health, Race/Ethnicity, and White Matter Hyperintensities
Funded Grant
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With ~560,000 Alzheimer’s disease (AD) patients and >4 million residents >65 years old, Florida is, and will continue to be, an epicenter of the AD epidemic in the United States. The 1Florida ADRC is a collaboration between Florida institutions, including the University of Florida (UF), Mt. Sinai Medical Center in Miami Beach (MSMC), University of Miami (UM), Florida International University (FIU), and Florida Atlantic University (FAU). The 1Florida ADRC’s global mission is to work with other ADRCs and stakeholders in the AD field to help change the understanding of AD and related dementias (ADRDs) to a new reality in which ADRDs are more facilely and accurately diagnosed, more effectively treated, and ultimately preventable or curable. Much of what we know about the natural history of AD, risk factors for cognitive decline, and response to interventions has come from study of Caucasian populations, largely of European descent. Multiple studies suggest a higher incidence of dementia among Hispanics and other underrepresented minority populations (URM), but whether these findings are broadly generalizable is unclear. Our successful recruitment and evaluation of a majority Hispanic cohort has enabled us to begin to evaluate whether there are differences in ADRDs between Hispanics and non- Hispanics in South Florida. Enhancing our understanding of dementia in ethnically and racially diverse populations is a major theme of our ADRC that will be expanded to include African Americans. As we transition towards an ADRC potentially funded as a P30, we will leverage our successful institutional and investigator partnerships to further expand our recruitment and longitudinal follow up of participants with ethnic, linguistic, cultural, and genetic diversity, as well as comorbidities associated with AD (e.g., vascular disease, Lewy Body Dementia (LBD)). Our overall specific aims are to: 1) Elucidate novel markers for the earliest prodromal stages of cognitive impairment and identify predictors of decline in our ethnically and racially diverse participants, who present with no or varied comorbidities. These longitudinal cohort studies, biomarker studies, and neuropathological studies will help the field to better understand AD, comorbidities, and disease heterogeneity. 2) Enhance our institutional research environments and provide resources to foster a) unique training opportunities; b) career development; and c) novel and innovative research in ADRDs with a growing emphasis on cross-disciplinary team science and advanced data analysis approaches. 3) Provide data, research tools and biospecimens to, and interact with, a wide variety of stakeholders within and outside (e.g., NACC, NCRAD) of our collaborating institutional network. 4) Provide educational activities relevant to ADRDs to health professionals, those in training, and to lay community members, with the goals of improving knowledge, developing skills, and building stronger coalitions to deliver better diagnoses and care to patients and their families.
