Could your neighborhood influence the health of your brain?

A recent $9.6 million award from the National Institute on Aging is helping the University of Pittsburgh and the RAND Corporation expand a longstanding research partnership to learn more about cognitive decline in Black Americans.

Ten years ago, researchers from RAND, a nonprofit research organization, began looking at health disparities across two predominantly Black neighborhoods in a study called the Pittsburgh Hill/Homewood Research on Neighborhood Change and Health study — abbreviated as PHRESH.

Initially, they looked at how factors like diet and body mass index (BMI) were associated with food deserts. A few years later, Pitt researchers brought their expertise to the study, looking at how neighborhood factors influenced sleep and cardiovascular health.

“Anecdotally, data collectors began noticing on home visits some of the participants were having memory problems,” said Andrea Rosso, associate professor of epidemiology in the School of Public Health, who is part of the PHRESH team.

On average, Americans start showing symptoms of Alzheimer’s disease and related dementias in their mid-60s. But these study participants were younger — in their mid-40s to early 50s, Rosso said — making her wonder if there might be a link to neighborhood factors.

Together with RAND senior policy researcher Tamara Dubowitz and senior behavioral and social scientist Wendy Troxel, who is also a Pitt faculty member, Rosso will lead a new PHRESH subproject to further examine how the lived experiences of being Black in America is associated with the risk of early onset Alzheimer’s disease and other dementias.

[Read more about the study in WESA.]

“Most of the research that's been done on risk and protective factors for dementia has been done in volunteer populations of predominantly white, predominantly well educated, higher socioeconomic status individuals,” said Rosso. “And so we know a fair amount about the risk factors in those groups. We don't know if those same risk factors then apply to other groups or not.” 

The goal of the new project, Rosso said, is to use historical neighborhood data along with current surveys, interviews and neuropsychology testing to pull back the curtain on structural racism’s impact on health.

Previous findings from the PHRESH study have shown that even changes in perceptions of neighborhood characteristics can affect things like heart health outcomes among residents. Associate Professor of Epidemiology Tiffany Gary-Webb led that research and is also working on the new study.

“We know that Pittsburghers tend to stay put,” said Rosso, while noting at the same time that gentrification has systematically pushed low-income families out of their neighborhoods.

The five-year study will focus not just on risk factors, but on potential protective factors that may guard against cognitive decline, including neighborhood social cohesion, safety and satisfaction, and sleep.

Hill Distict and Homewood community members are already engaged in data collection for the cognitive arm of the PHRESH study (called THINK PHRESH), which is set to begin over the summer, Rosso said. Over 1,000 people from their 30s to their 70s are enrolled.

The team hopes that asking more and better questions will provide a more robust framework for future research. They’re adding a new qualitative component to the study to help build this framework by listening to and learning from the community.

“We’re actually going to interview some people and have them tell us what they think about cognition and aging, what they think about the things that they've done in their life that are risky or protective,” said Rosso. “We aren't going with our lens so that the people in the communities can inform us as to what we should be looking at.”

The current award is for five years, but as Rosso said, investigating structural racism is a long-term commitment. The team has plans for future work and is hopeful that funding for studies like these will continue to be available long into the future.

— Micaela Corn