评估基于种族的认知规范模型的基于健康的替代品的社会决定因素
Andrea Lauren Christman Schneider1, Anny Reyes1, James A Henegan1
1From the Department of Neurology (A.L.C.S.); Department of Biostatistics, Epidemiology, and Informatics, (A.L.C.S.), University of Pennsylvania Perelman School of Medicine, Philadelphia; Department of Radiation Medicine and Applied Sciences (A.R.), University of California, San Diego; Memory Impairment and Neurodegenerative Dementia (MIND) Center (J.A.H., T.H.M., M.G.), University of Mississippi Medical Center, Jackson; Department of Psychiatry and Behavioral Sciences (V.K.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Biostatistics and Bioinformatics (L.W.), Duke University, Durham, NC; Department of Population Health (J.R.P., J.C.), New York University Grossman School of Medicine, New York; Department of Epidemiology (A.G.), Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD; National Institute on Aging Intramural Program (K.W.), Baltimore, MD; Department of Epidemiology (A.K.-N.), University of North Carolina at Chapel Hill; and National Institute of Neurologic Disorders and Stroke Intramural Research Program (R.F.G.), Bethesda, MD.
健康的社会决定因素,如教育质量,比邻居的贫困更能解释认知表现的变化. 然而,这些因素并没有完全解释认知测试中的种族差异.
科学领域:
- 认知衰老的研究研究.
- 在健康方面存在差异.
- 社会文化对认知的影响.
背景情况:
- 种族和民族是影响认知测试表现的社会文化因素的代理.
- 了解历史上归因于种族的认知性能变异性至关重要.
研究的目的:
- 比较基于回归的认知规范模型.
- 根据人口统计和健康的社会决定因素 (SDoH) 进行调整.
- 确定解释认知表现变化的SDoH因素.
主要方法:
- 黑人和白人参与者的横截面分析 (社区动脉样硬化风险研究).
- 11个认知测试跨越记忆,执行功能和语言领域.
- 将规范模型与年龄,教育,种族,教育质量 (WRAT) 和社区贫困 (ADI) 相匹配.
主要成果:
- "完整"模型 (种族,人口统计,SDoH) 在大多数认知测试中表现优于嵌套模型.
- 教育质量 (WRAT) 在记忆和语言方面表现优于社区贫困 (ADI).
- 与白人参与者相比,在黑人参与者中观察到更大的认知表现不一致.
结论:
- 教育质量是认知衰老研究中的一个有价值的SDoH指标.
- 常规收集的SDoH变量不能完全解释认知表现中的种族差异.
- 未来的研究需要在不同的人群中检查寿命SDoH.
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