• Login
    View Item 
    •   Home
    • UA Graduate and Undergraduate Research
    • UA Theses and Dissertations
    • Dissertations
    • View Item
    •   Home
    • UA Graduate and Undergraduate Research
    • UA Theses and Dissertations
    • Dissertations
    • View Item
    JavaScript is disabled for your browser. Some features of this site may not work without it.

    Browse

    All of UA Campus RepositoryCommunitiesTitleAuthorsIssue DateSubmit DateSubjectsPublisherJournalThis CollectionTitleAuthorsIssue DateSubmit DateSubjectsPublisherJournal

    My Account

    LoginRegister

    About

    AboutUA Faculty PublicationsUA DissertationsUA Master's ThesesUA Honors ThesesUA PressUA YearbooksUA CatalogsUA Libraries

    Statistics

    Most Popular ItemsStatistics by CountryMost Popular Authors

    The Role of Cumulative Advantage/Disadvantage in Disparities in Alzheimer's Disease Risk

    • CSV
    • RefMan
    • EndNote
    • BibTex
    • RefWorks
    Thumbnail
    Name:
    azu_etd_16992_sip1_m.pdf
    Size:
    22.62Mb
    Format:
    PDF
    Download
    Author
    Peterson, Rachel L.
    Issue Date
    2019
    Keywords
    African American
    Cognitive Aging
    Health disparities
    Inequality
    Race
    Social Status
    Advisor
    Carvajal, Scott
    
    Metadata
    Show full item record
    Publisher
    The University of Arizona.
    Rights
    Copyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction, presentation (such as public display or performance) of protected items is prohibited except with permission of the author.
    Abstract
    BACKGROUND: Substantial disparities have been observed in Alzheimer’s disease (AD) by race and social class. The persistence of health disparities over time and for diseases with distinct etiological processes suggests that the fundamental cause may reside within processes of advantage and disadvantage that accumulate across the life course. Although education is a well established risk factor for AD, it is unclear if the mechanistic role of education in AD disparities is through direct cognitive stimulation – the most commonly accepted hypothesis in AD research – or if it operates indirectly as a marker of social status and discrimination. OBJECTIVES: This dissertation aims to answer the question of how social processes at different points in the life course produce socioeconomic and racial inequalities in Alzheimer’s disease risk. This question is broken into a series of three studies that examine the existing evidence for the role of modifiable risk factors in AD, and test for the role of cumulative advantage/disadvantage in the context of socioeconomic, and racial disparities. METHODS: Study one is a structured narrative review of studies that tested for differences by race of the effect of any of six modifiable risk factors (education, obesity, smoking, physical activity, social isolation, and psychosocial stress) for AD risk. Study two used a Generalized Estimating Equation to examine the effect of individual SES and state-level income inequality on Subjective Cognitive Decline, as reported in the Cognitive Decline module of the Behavioral Risk Factor Surveillance System. Study three used structural equation modeling to conduct mediation and conditional process analysis (moderated mediation) to examine the role of markers of socioeconomic status and stress in racial disparities in AD risk among participants of the National Social Life Health and Aging Project. RESULTS: Of 3,464 identified studies in study one, 45 tested for differences in the modifiable risk factors by race. Education was the most widely examined risk factor, and the only factor in the review with strong evidence for a role in racial disparities. In study two, a dose-response effect was observed for income while those with high school education reported better cognition than those with some college. State-level income inequality was not associated with cognitive decline. In study three, education consistently mediated the race-cognition pathway, and perceived stress and assets mediated the education-cognition pathway. In all models, the direct effect of race on cognition remained large. CONCLUSIONS: Combined, these studies confirmed the importance of education for socioeconomic and racial disparities in AD risk, but suggested that education operates as an indicator of social status and discrimination, as well as through its role via cognitive stimulation. These findings point to the importance of considering social factors from across the life course in public health research and interventions aiming to understand and reduce disparities in AD risk.
    Type
    text
    Electronic Dissertation
    Degree Name
    Ph.D.
    Degree Level
    doctoral
    Degree Program
    Graduate College
    Public Health
    Degree Grantor
    University of Arizona
    Collections
    Dissertations

    entitlement

     
    The University of Arizona Libraries | 1510 E. University Blvd. | Tucson, AZ 85721-0055
    Tel 520-621-6442 | repository@u.library.arizona.edu
    DSpace software copyright © 2002-2017  DuraSpace
    Quick Guide | Contact Us | Send Feedback
    Open Repository is a service operated by 
    Atmire NV
     

    Export search results

    The export option will allow you to export the current search results of the entered query to a file. Different formats are available for download. To export the items, click on the button corresponding with the preferred download format.

    By default, clicking on the export buttons will result in a download of the allowed maximum amount of items.

    To select a subset of the search results, click "Selective Export" button and make a selection of the items you want to export. The amount of items that can be exported at once is similarly restricted as the full export.

    After making a selection, click one of the export format buttons. The amount of items that will be exported is indicated in the bubble next to export format.