Heterogeneous Effects of Education on Alzheimers Disease and Related Dementia among Demographic Groups: A Multigenerational and Multilevel Study

PROJECT SUMMARY The protective effect of education against Alzheimer’s disease and related dementias (ADRD) is found to be smaller for Black and Hispanic people than for non-Hispanic white people. Identifying biopsychological, behavioral, and healthcare-related factors that modify or mediate the heterogeneous education-ADRD relationship presents a unique opportunity to address the sociodemographic disparities in ADRD and ultimately improve population health. However, most research relies on a person’s own education, failing to consider the roles of other family member’s education or the context and environment in which education occurs and affects ADRD. The major goal of the proposed research is to develop a novel framework that incorporates multigenerational education and multidomain contextual measures and use it to identify psychological, behavioral, and healthcare-related factors (e.g., stress, physical activity, and preventive health screenings) that lead to the heterogeneous effects of education on ADRD risk among sociodemographic groups by analyzing nationally representative longitudinal data. We propose to achieve this goal through three specific aims. In Aim 1, we will develop a multigenerational framework and use it to estimate the effect of multigenerational education on the respondent’s ADRD risk and the sociodemographic disparities. Aim 2 is to construct multidomain measures of contextual resources (e.g., school and residential segregation, crime rates, access to health care, and population compositions of college graduates) and estimate their effects on individual’s ADRD risk. To provide historical and population contexts for understanding results from Aims 1 and 2, in Aim 3 we will estimate how education effects on ADRD risk and the related biopsychological, behavioral, and healthcare-related mechanisms may differ across four birth cohorts. The proposed research is significant because it will help reduce population risk of ADRD and related sociodemographic disparities by identifying biopsychological, behavioral, and healthcare-related factors that operate at the individual and contextual levels leading to heterogeneous education-ADRD relationships. The proposed research is innovative because it will develop a new multigenerational and multilevel mediation approach to understanding why the education-ADRD risk relationship differs among socioeconomic groups. It will also contribute new contextual data to a nationally representative dataset.