Cognitive impairment and dementia continue to threaten the aging population. Although no one is immune, certain groups, namely black older persons, are more likely to have a diagnosis of certain dementias. Because researchers have not found a purely biological reason for this disparity, they have turned to a biopsychosocial model. Specifically, black persons in the United States are more likely to live with social conditions that affect their stress levels which in turn affect physiological regulation leading to conditions that result in higher levels of cognitive impairment or dementia. Here we discuss some of these social conditions such as discrimination, education, and socioeconomic status, and how physiological dysregulation, namely allostatic load that can lead to cognitive impairment and dementia in black persons especially.

Biological age (BA) is a construct that captures accelerated biological aging attributable to "wear and tear" from various exposures; we measured BA and weathering, defined as the difference between BA and chronological age, and their associations with race and psychosocial factors in a middle-aged bi-racial cohort. We used data from the Coronary Artery Risk in Young Adults study (CARDIA), conducted in 4 U.S. cities from 1985-2016 to examine weathering for adults aged 48-60 years. We estimated BA via the Klemera and Doubal method using selected biomarkers. We assessed overall and race-specific associations between weathering and psychosocial measures. For the 2694 participants included, Blacks had a BA (SD) that was 2.6 (11.8) years older than their chronological age while the average BA among Whites was 3.5 (10.0) years younger than their chronological age (Blacks weathered 6.1 years faster than Whites). Belonging to more social groups was associated with less weathering in Blacks but not Whites, and after multivariable adjustment, lower SES and more depressive symptoms were associated with more weathering among Blacks than among Whites. We confirmed racial differences in weathering, and newly documented that similar psychosocial factors may take a greater toll on the biological health of Blacks than Whites.

Background: A number of studies have linked neuropsychiatric symptoms to increase risk of dementia. Objective: To determine if risk of conversion to mild cognitive impairment or dementia among healthy controls varied as a function of their pattern o