Introducing the Study of Healthy Aging in African Americans (STAR): Looking back to move forward

Abstract

AbstractBackgroundRates of dementia and Alzheimer’s disease are 40‐100% higher in African Americans versus non‐Hispanic whites. Yet there’s a lack of information on cognitive aging starting from midlife in African Americans and on lifecourse risk and protective factors. The Study of Healthy Aging in African Americans (STAR; RF1AG050782) is an ongoing cohort study of African‐American men and women ages 50+ aiming to (1) characterize heterogeneity in longitudinal change in cognition; (2) evaluate effects of exposure to vascular risk, psychosocial factors and early life experience over 50 years; and (3) evaluate structural MRI imaging markers of brain status on domain‐specific cognitive function.MethodEnrollment is ongoing and as of Dec 2019, STAR has enrolled 722 individuals of which 333 have completed a second visit. Eligible individuals were non‐demented Kaiser Permanente Northern California (KPNC) members age ≥50 (equal sampling of ages 50‐64 and 65+) who participated in KPNC Multiphasic Health Checkups (MHC) during at least 1 MHC phase (1964‐1973 or 1977‐1985) out of 5. MHC data and KPNC electronic medical record data are linked to lifecourse factors, psychosocial factors, the Spanish and English Neuropsychological Assessment Scales (SENAS), anthropometrics, physical function, and saliva samples from in‐person interviews. In‐person interviews will be repeated every 16 months for a total of 3 follow‐up visits, with a random subsample receiving MRI scans.ResultAmong the first 722 participants enrolled, average baseline age was 68.4. The sample was 68.7% female and a greater proportion of women than men were 50‐64 yrs (46.2% vs 36.3%). 58.4% of men and 36.1% of women were married or living with a partner. 15.1% of the sample had ≤high school education and 18.6% completed graduate school. 30.9% report excellent or very good health and 34.2% were born in a Southern state. 20% of men and 18% of women reported ever being unfairly denied a bank loan. Participants had an average of 2.3 out of 5 MHC phases; almost 15% participated in all 5 phases.ConclusionSTAR is an unprecedented lifecourse study of late‐life cognitive among African Americans with extensive prospectively collected health history.