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. 2024 Feb;20(2):1360-1373.
doi: 10.1002/alz.13544. Epub 2023 Nov 22.

Empirically derived psychosocial-behavioral phenotypes in Black/African American and Hispanic/Latino older adults enrolled in HABS-HD: Associations with AD biomarkers and cognitive outcomes

Affiliations

Empirically derived psychosocial-behavioral phenotypes in Black/African American and Hispanic/Latino older adults enrolled in HABS-HD: Associations with AD biomarkers and cognitive outcomes

Alexandra L Clark et al. Alzheimers Dement. 2024 Feb.

Abstract

Introduction: Identification of psychosocial-behavioral phenotypes to understand within-group heterogeneity in risk and resiliency to Alzheimer's disease (AD) within Black/African American and Hispanic/Latino older adults is essential for the implementation of precision health approaches.

Methods: A cluster analysis was performed on baseline measures of socioeconomic resources (annual income, social support, occupational complexity) and psychiatric distress (chronic stress, depression, anxiety) for 1220 racially/ethnically minoritized adults enrolled in the Health and Aging Brain Study-Health Disparities (HABS-HD). Analyses of covariance adjusting for sociodemographic factors examined phenotype differences in cognition and plasma AD biomarkers.

Results: The cluster analysis identified (1) Low Resource/High Distress (n = 256); (2) High Resource/Low Distress (n = 485); and (3) Low Resource/Low Distress (n = 479) phenotypes. The Low Resource/High Distress phenotype displayed poorer cognition and higher plasma neurofilament light chain; differences between the High Resource/Low Distress and Low Resource/Low Distress phenotypes were minimal.

Discussion: The identification of psychosocial-behavioral phenotypes within racially/ethnically minoritized older adults is crucial to the development of targeted AD prevention and intervention efforts.

Keywords: Alzheimer's disease; psychosocial-behavioral phenotypes; racial disparities; social determinants of health.

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Conflict of interest statement

The authors have no conflicts of interest to report. Author conflict of interest disclosures are available in the supporting information.

Figures

FIGURE 1
FIGURE 1
Psychosocial‐behavioral phenotypes of all racially/ethnically minoritized HABS‐HD older adults. Top: bar graph of mean resource and psychiatric factors across identified clusters. Bottom: violin plot showing distribution across mean resource and psychiatric factors across identified clusters.
FIGURE 2
FIGURE 2
Psychosocial‐behavioral phenotypes of Latino and Black older adults only. Top: bar graph of mean resource and psychiatric factors across identified clusters in Latino older adults. Bottom: bar graph of mean resource and psychiatric factors across identified clusters in Black older adults.
FIGURE 3
FIGURE 3
Psychosocial‐behavioral phenotypes and subjective/objective cognition. Top: boxplot of subjective memory concerns across clusters. Bottom: boxplot of performance on executive functioning composite across clusters.
FIGURE 4
FIGURE 4
Boxplot of neurofilament light chain across psychosocial phenotypes.

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