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RACIAL DISCRIMINATION DURING MIDDLE AGE PREDICTS HIGHER SERUM PHOSPHORYLATED TAU AND NEUROFILAMENT LIGHT CHAIN LEVELS A DECADE LATER
Abstract
Aims
Black Americans have a greater risk of developing dementia compared to White Americans. Exposure to racial discrimination and high levels of perceived stress and trauma are associated with cognitive decline. However, the underlying biological mechanisms by which stress and discrimination contribute to cognitive decline are not understood. We assessed whether cumulative exposure to racial discrimination during middle age predicted change in Alzheimer’s disease and neurodegeneration-related blood biomarkers over an 11-year period.
Methods
We used psychosocial and demographic data from 255 Black Americans enrolled in the Family and Community Health Study (FACHS). Participants completed the Schedule of Racist Events at three visits between 2002 and 2008. In 2008 and 2019, serum was obtained. Measures of phosphorylated tau 181 (P-tau181), neurofilament light chain (NfL), and glial fibrillary acidic protein (GFAP) were assayed on the Quanterix simoa HD-X analyzer. We hypothesized that discrimination assessed during middle age would predict increases in these serum biomarkers as the participants aged into their 60s.
Results
In 2008, participants were a mean (standard deviation, SD) age of 46 (6.3) years; 19.3% had an education level below 12 years; and 45.3% had income below 150% of the federal poverty level. Higher reported discrimination between 2002 and 2008 was not associated with serum biomarkers in 2008. However, higher levels of reported discrimination was associated with a greater increase in levels of both P-tau181 (b=0.183, p=0.003) and NfL (b=1.42, p=0.014) between 2008 and 2019 in models adjusting for age, education, BMI, and gender. Discrimination was not associated with subsequent levels of GFAP.
Conclusions
These findings suggest that early racial discrimination is associated with increased AD pathology and neurodegeneration later in life among Black Americans.