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WELCOME TO

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THOSE HERE IN THE CONFERENCE

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ROOM AND THOSE ONLINE.

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IT'S MY GREAT PLEASURE TO

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WELCOME YOU TO THE FLORENCE

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MAHONEY LECTURE, AND OUR

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LECTURER, JEN MANLY, WHO'S GOING

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TO BE TALKING ABOUT POLICIES TO

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PTAU.

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WE'LL INTRODUCE HER IN MORE

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DETAIL LATER BUT FIRST SOME

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HOUSEKEEPING TOPICS.

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FOR THOSE LOOKING FOR C MSME

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CREDIT, 50124 IS THE CODE.

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FOR THE REST OF YOU, PLEASE DO.

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IN TERMS OF FEEDBACK, FOR THOSE

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ONLINE, USE THE "SEND LIVE

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FEEDBACK" BUTTON ON THE

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VIDEOCAST AND AT THE END OF THE

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MEETING, WE WILL READ AND GET

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RESPONSES FROM JEN TO YOUR

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QUESTIONS AND FOR THOSE HERE IN

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THE ROOM, WE HAVE A COUPLE OF

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MICROPHONES THAT WILL BE LIVE AT

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THE END AS WELL.

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WITH THAT HOUSEKEEPING OUT OF

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THE WAY, LET ME JUST INTRODUCE

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FIRST THE FLORENCE MAHONEY

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LECTURE IS NAMED OBVIOUSLY FOR

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FLORENCE MAHONEY, AN OUTSTANDING

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WOMAN WHO ALONG WITH MARY LASKER

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WAS RESPONSIBLE FOR MANY OF THE

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INNOVATIONS AND CONGRESSIONAL

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ACTIONS THAT ESTABLISHED

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COMPONENTS OF NIH, NOTABLY NIA.

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I HAD THE GREAT PLEASURE FOR

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MANY YEARS OF KNOWING HER AND

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MEETING WITH HER AT HER HOME IN

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GEORGETOWN, AND IT WAS ALWAYS

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INTO THE ADVANCED AGE, OVER 100

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WHEN WE LAST MET, DIED I THINK

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AT THE AGE OF 103, BUT TO THE

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END, SHE WAS VITAL AND

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INTERESTED IN THESE LECTURES,

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SHE SAID I DON'T WANT ANY

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NONSENSE.

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I WANT YOU TO HAVE GREAT

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SPEAKERS WHO ARE TALKING ABOUT

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REAL HARD SCIENCE.

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THAT'S WHAT I WANT.

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AND WE WOULD DISCUSS WHO WAS

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COMING UP NEXT, SHE WOULD

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APPROVE AND SHE WOULD BE

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THRILLED, OF COURSE, WITH

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JENNIFER BEING HERE NOW.

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THE OTHER ANNIVERSARY WE'RE

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MARKING NOW IS THE 50TH

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ANNIVERSARY OF NIA SINCE ITS

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INCEPTION, SO ACCOUNT THIS AND

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JEN'S PRESENCE AS AN IMPORTANT

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PART OF THAT CELEBRATION.

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SO NOW JUST TO BRIEFLY INTRODUCE

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JENNIFER TO YOU, SHE DID HER

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UNDERGRADUATE WORK AT UC

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BERKELEY, THEN HER GRADUATE WORK

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AT UC SAN DIEGO BEFORE GOING TO

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CRUMB GLCOLUMBIA.

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SHE'S DONE OUTSTANDING GROUP --

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A RARE ACCOMPLISHMENT IN LINKING

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SOCIAL, ENVIRONMENTAL

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DETERMINANTS TO CLINICAL

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OUTCOMES AND TO THE BIOLOGIC

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BIOMARKERS IN BETWEEN, ALL

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CAPTURED IN HER TITLE HERE,

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POLICIES TO PTAU, SOCIAL AND

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STRUCTURAL DRIVERS OF

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ALZHEIMER'S DISEASE,

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OPPORTUNITIES FOR BRAIN HEALTH

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AND JUSTICE.

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HER CAREER HAS BEEN PROLIFIC,

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EXEMPLARY AND NOTABLE FOR MANY

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ASPECTS BUT FOR ONE AMONG THE

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MANY, THE WAY IN WHICH SHE HAS

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MADE COMMUNITY ENGAGEMENT WORK

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AND DEMONSTRATED THE CRITICAL

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IMPORTANCE OF ENGAGEMENT WITH

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COMMUNITIES FOR THE KIND OF

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RESEARCH THAT NEEDS TO BE DONE.

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SHE TAUGHT US ALL LESSONS,

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SERVED ON OUR ADVISORY COUNCIL

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AND HELPED US THERE, AND NOW

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SHE'S HERE TO IMPART SOME OF HER

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WISDOM TO ALL OF YOU.

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SO JEN, IT'S A PLEASURE TO HAVE

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YOU HERE.

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WELCOME.

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[APPLAUSE]

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>> THANK YOU SO MUCH, RICHARD.

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IT REALLY IS AN HONOR TO BE WITH

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YOU TODAY.

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I DID READ "THE NEW YORK TIMES"

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OWE OBITUARY, INTERESTING FOR MY

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REASONS, AS YOU SAID, SHE WAS A

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CONSTANT ADVOCATE, AND THE OTHER

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THING WAS THAT SHE SAID THAT SHE

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DIDN'T BOTHER -- YOU KNOW, SHE

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NEEDED SOMETHING, SHE JUST WENT

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STRAIGHT TO THE TOP.

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SO THAT MEANT GOING TO THE

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PRESIDENT, WHOEVER IT WAS AT THE

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TIME, AND APPARENTLY THEY WOULD

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GROAN WHEN THEY SAW HER BECAUSE

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THEY KNEW SHE WAS GOING TO BE

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ASKING FOR MORE FUNDING FOR THE

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NATIONAL INSTITUTES OF HEALTH

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AND SPECIFICALLY THE NATIONAL

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INSTITUTES ON AGING.

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SO HAPPY ANNIVERSARY, AND I AM

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EXTREMELY PROUD AND HONORED TO

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BE HERE.

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I AM GOING TO THANK THE GROUP OF

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PEOPLE THAT I WORK WITH AT

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COLUMBIA UNIVERSITY.

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THEY ARE REALLY THE GEARS THAT

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MAKE EVERYTHING WORK, AND THE

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FUNDING THAT SUPPORTS THE WORK

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THAT I DO.

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OTHER THAN THESE NIH GRANTS, I

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DON'T HAVE ANY DISCLOSURES.

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SO FIRST I'M GOING TO REMIND ALL

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OF YOU IN THE ROOM, BECAUSE I

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RECOGNIZE MANY OF YOU, I KNOW

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THAT I DON'T HAVE TO DO THIS IN

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DETAIL, BUT I'M GOING TO REMIND

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YOU OF THE SCOPE OF THE

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CHALLENGE THAT WE'RE FACING.

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THIS IS A LINE GRAPH THAT SHOWS

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THE INCREASE IN MILLIONS OF

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PEOPLE WITH DEMENTIA IN LOW AND

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MIDDLE INCOME COUNTRIES COMPARED

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TO HIGH-INCOME COUNTRIES FROM

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2013 TO 2050.

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SO WHAT WE ARE ESTIMATING IS

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THAT BY 2025, MORE THAN 70% OF

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THE GLOBAL DEMENTIA POPULATION

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WILL LIVE IN LOW AND MIDDLE

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INCOME COUNTRIES, AND RIGHT NOW,

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DEMENTIA IS THE FIFTH LEADING

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CAUSE OF DEATH WORLDWIDE, AND BY

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2028, THE COST OF DEMENTIA CARE,

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THAT INCLUDES FORMAL MEDICAL

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CARE AND ALSO INFORMAL

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CAREGIVING COSTS, WILL BE MORE

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THAN 2 TRILLION U.S. DOLLARS

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WORLDWIDE.

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SO WE MUST INTERVENE TO REDUCE

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THE CURRENT AND FUTURE BURDEN OF

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DEMENTIA WORLDWIDE, AND WHAT

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THAT MEANS IS THAT WE NEED TO

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IDENTIFY MODIFIABLE FACTORS,

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MODIFIABLE RISK FACTORS,

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MODIFIABLE RESILIENCE FACTORS.

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AND SO THIS FIGURE, WHICH ALL OF

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YOU HAVE SEEN A THOUSAND TIMES

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BECAUSE IT'S SO COMPELLING, FROM

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THE LIVINGSTON SYSTEMATIC REVIEW

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IN LANCET IN 2020, ESSENTIALLY

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CARRIES US THROUGH THE LIFE

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COURSE, AND THE SIZE OF EACH OF

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THESE CIRCLES THAT REPRESENTS A

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MODIFIABLE RISK FACTOR IS

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DETERMINED BASED ON HOW COMMON

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THAT RISK FACTOR IS AND ALSO ITS

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STRENGTH OF IMPACT ON DEMENTIA

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RISK.

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AND THAT PERCENTAGE THAT YOU SEE

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WITHIN EACH CIRCLE IS THE

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PERCENT REDUCTION IN DEMENTIA

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PREVALENCE IF THE RISK FACTOR IS

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ELIMINATED.

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SO BY THE TIME YOU GET TO THE

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END, YOU FIND THAT AROUND 40% OF

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DEMENTIA IS CONSIDERED

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MODIFIABLE USING THE BEST

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EVIDENCE THAT THEY HAD AT THE

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TIME FOR THIS REVIEW.

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AND THAT IS A TREMENDOUS AMOUNT

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THAT WE CAN DO TO PRESERVE

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COGNITIVE HEALTH.

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AND BECAUSE MODIFIABLE FORCES

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LIKE THE ONES THAT ARE LISTED

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HERE ARE THE CAUSE OF ANY

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QUALITIES IN COGNITIVE

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IMPAIRMENT AND DEMENTIA, THIS

195
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ALSO SUGGESTS THERE ARE

196
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TREMENDOUS OPPORTUNITIES TO

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NARROW DISPARITIES.

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BUT THESE DATA ARE BASED ALMOST

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ENTIRELY ON DATA FROM WHITE

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PEOPLE IN HIGH-INCOME COUNTRIES.

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SO I ALWAYS SHOW THIS BECAUSE I

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LOVE WHAT ROCK NEONOGO DID,

203
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WHICH IS TO USE U.S.

204
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REPRESENTATIVE DATA ON

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PREVALENCE ESTIMATES OF THOSE

206
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NOT GUYABLEMODIFIABLE RISK FACT.

207
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HE USED THE BURFS TO GET THOSE

208
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DATA, AND THEN IN EACH RACIAL

209
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AND ETHNIC GROUP THAT HE HAD

210
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INFORMATION FOR.

211
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WHAT HE FOUND WAS THE PROPORTION

212
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OF ALZHEIMER'S DISEASE AND

213
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RELATED DEMENTIAS ASSOCIATED

214
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WITH THE TOP MODIFIABLE RISK

215
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FACTORS WAS RELATIVELY HIGHER

216
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AMONG MEN VERSUS WOMEN, AND

217
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AMONG BLACK INDIVIDUALS,

218
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AMERICAN INDIAN AND ALASKA

219
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NATIVE INDIVIDUALS AND HISPANIC

220
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INDIVIDUALS COMPARED WITH ASIANS

221
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AND WHITES.

222
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SO THIS, I THINK, UNDERSCORES

223
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THE IMPORTANCE OF NATIONALLY

224
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REPRESENTATIVE DATA WHERE THE

225
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SAMPLING ALLOWS FOR GROUP

226
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COMPARISONS AND ALSO TO INFORM

227
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OPTIMAL PREVENTION EFFORTS IN

228
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GROUPS THAT EXPERIENCE HIGHER

229
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BURDEN OF COGNITIVE IMPAIRMENT

230
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AND DEMENTIA.

231
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SO WHAT IS THE BEST WAY FOR US

232
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TO EXAMINE THESE MODIFIABLE RISK

233
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AND RESILIENCE FACTORS AND TO

234
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DEVELOP STRATEGIES FOR NARROWING

235
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DISPARITIES?

236
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WITH THE GOAL TO EXTEND --

237
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HOPEFULLY TO EXTEND COGNITIVE

238
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LIFE EXPECTANCY FOR EVERYONE,

239
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AND MINIMIZE DISABILITY D DUE TO

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COGNITIVE IMPAIRMENT?

241
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IT REALLY DEMANDS A LIFE COURSE

242
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PERSPECTIVE WHICH ALL OF YOU AT

243
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NIA ARE DEEPLY FAMILIAR WITH.

244
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BUT I THINK IT'S RELATIVELY NEW,

245
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A LIFE COURSE PERSPECTIVE, FOR

246
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PEOPLE WHO STUDY ALZHEIMER'S

247
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DISEASE.

248
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SO I'M GOING TO BRING YOU

249
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THROUGH ONE HERE THAT SORT OF

250
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GUIDES MY WORK.

251
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AND WE'RE GOING TO START WITH

252
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PROXIMAL CAUSES OF COGNITIVE

253
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IMPAIRMENT AND DEMENTIA.

254
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ALZHEIMER'S DISEASE PATHOLOGY

255
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AND VASCULAR DEMENTIA ARE

256
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PROBABLY THE MOST COMMON

257
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DEMENTIA SUBTYPES OR THE

258
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PATHOLOGY SUBTYPES IN THE UNITED

259
00:08:59,205 --> 00:09:01,574
STATES.

260
00:09:01,641 --> 00:09:04,744
AND YOU CAN SEE THAT I'M

261
00:09:04,810 --> 00:09:06,579
STARTING IN THE BRAIN, AND

262
00:09:06,646 --> 00:09:08,781
LEADING TO COGNITIVE FUNCTION

263
00:09:08,848 --> 00:09:10,650
AND DEMENTIA ON THE RIGHT SIDE

264
00:09:10,716 --> 00:09:15,021
OF THIS PROCESS.

265
00:09:15,087 --> 00:09:19,492
AND THEN WE HAVE THINGS THAT CAN

266
00:09:19,558 --> 00:09:23,763
BE SEEN IN THE CLINIC WHEN

267
00:09:23,829 --> 00:09:26,065
PEOPLE SHOW UP AT THE CLINIC,

268
00:09:26,132 --> 00:09:27,366
BOTH RISK AND RESILIENCE

269
00:09:27,433 --> 00:09:29,235
FACTORS, AND I WONDER IF MY

270
00:09:29,302 --> 00:09:30,202
RESILIENCE FACTORS ARE GOING TO

271
00:09:30,269 --> 00:09:31,437
SHOW UP AT SOME POINT, BUT

272
00:09:31,504 --> 00:09:32,838
THEY'RE IN HERE.

273
00:09:32,905 --> 00:09:35,274
ESSENTIALLY POINTING OUT THAT

274
00:09:35,341 --> 00:09:39,245
THERE ARE NOT JUST FACTORS THAT

275
00:09:39,312 --> 00:09:42,048
RELATE TO DEFICIT IN ONE'S

276
00:09:42,114 --> 00:09:43,783
ENVIRONMENT, BUT ALSO FACTORS

277
00:09:43,849 --> 00:09:49,155
THAT RELATE TO STRENGTHS.

278
00:09:49,221 --> 00:09:50,489
THE THINGS WE CAN SEE IN THE

279
00:09:50,556 --> 00:09:56,595
HERE AND NOW, LIKE DISEASES THAT

280
00:09:56,662 --> 00:09:57,663
INCREASE RISK FOR ALZHEIMER'S

281
00:09:57,730 --> 00:09:59,865
PATHOLOGY AND COGNITIVE

282
00:09:59,932 --> 00:10:03,903
IMPAIRMENT ARE INFLUENCED BY

283
00:10:03,970 --> 00:10:04,904
THESE SOCIAL DETERMINANTS OF

284
00:10:04,971 --> 00:10:08,074
HEALTH.

285
00:10:08,140 --> 00:10:11,344
I LIKE TO TALK ABOUT RESILIENCE

286
00:10:11,410 --> 00:10:14,313
FACTORS BECAUSE THEY INTERACT

287
00:10:14,380 --> 00:10:16,615
WITH RISK FACTORS.

288
00:10:16,682 --> 00:10:20,453
THERE WAS A REALLY NICE STUDY

289
00:10:20,519 --> 00:10:22,488
WHERE EVEN THOUGH BLACK OLDER

290
00:10:22,555 --> 00:10:24,156
ADULTS REPORTED GREATER EXPOSURE

291
00:10:24,223 --> 00:10:29,095
THAN WHITE OLDER ADULTS, THEY'RE

292
00:10:29,161 --> 00:10:30,262
LESS UPSETTING THAN WHITES.

293
00:10:30,329 --> 00:10:32,198
SO EVEN THOUGH STRESS APPRAISAL

294
00:10:32,264 --> 00:10:37,470
DIDN'T REALLY MODERATE THOSE,

295
00:10:37,536 --> 00:10:39,572
APPRAISING STRESSORS AS LESS

296
00:10:39,638 --> 00:10:40,406
UPSETTING WAS ASSOCIATED WITH

297
00:10:40,473 --> 00:10:43,609
BETTER MEMORY IN BLACK ADULTS.

298
00:10:43,676 --> 00:10:45,578
AND SO I'M POINTING OUT HERE,

299
00:10:45,644 --> 00:10:47,546
YOU CAN SEE WHERE RACE AND

300
00:10:47,613 --> 00:10:49,615
ETHNICITY IS IN MY MODEL, RACE

301
00:10:49,682 --> 00:10:51,917
AND ETHNICITY IS A DOWNSTREAM

302
00:10:51,984 --> 00:10:52,351
FACTOR.

303
00:10:52,418 --> 00:10:54,653
THE CLASSIFICATIONS OF RACE AND

304
00:10:54,720 --> 00:10:58,624
ETHNICITY IN THESE MODELS CONOTE

305
00:10:58,691 --> 00:11:00,593
THAT THOSE CLASSIFICATIONS ARE

306
00:11:00,659 --> 00:11:02,528
MADE, THEY ARE HISTORICAL,

307
00:11:02,595 --> 00:11:05,264
POLITICAL, ECONOMIC, AND

308
00:11:05,331 --> 00:11:06,599
CULTURAL, AND I SAW A TWEET THE

309
00:11:06,665 --> 00:11:11,937
OTHER DAY FROM DEDRIC WILLIAMS

310
00:11:12,004 --> 00:11:13,139
WHICH SAID RACISM MAKES THE IDEA

311
00:11:13,205 --> 00:11:13,706
OF RACE POSSIBLE.

312
00:11:13,773 --> 00:11:15,207
AND I LIKE HOW THAT'S PHRASED.

313
00:11:15,274 --> 00:11:16,475
AND THAT'S WHAT I'M TRYING TO

314
00:11:16,542 --> 00:11:17,843
CONOTE WITH THE ARROWS GOING

315
00:11:17,910 --> 00:11:19,245
INTO THE RACE BOX.

316
00:11:19,311 --> 00:11:22,548
HERE.

317
00:11:22,615 --> 00:11:23,416
SO STRUCTURAL AND SOCIAL

318
00:11:23,482 --> 00:11:25,718
DETERMINANTS OF HEALTH CAN

319
00:11:25,785 --> 00:11:28,254
BUFFER OR EXACERBATE RISK.

320
00:11:28,320 --> 00:11:30,756
WHAT YOU CAN SEE AT THE CORE OF

321
00:11:30,823 --> 00:11:32,391
THIS LIFE COURSE MODEL IS

322
00:11:32,458 --> 00:11:33,826
HISTORICAL AND CONTEMPORARY

323
00:11:33,893 --> 00:11:38,964
SYSTEMS OF OPPRESSION, DPIS CRIM

324
00:11:39,031 --> 00:11:40,166
DISCRIMINATORY BELIEFS AND ALSO

325
00:11:40,232 --> 00:11:41,167
THE INSTITUTIONAL POWER THAT

326
00:11:41,233 --> 00:11:42,134
COMES ALONG WITH THOSE BELIEFS.

327
00:11:42,201 --> 00:11:43,969
I ADDED A NEW ONE FOR THIS TALK,

328
00:11:44,036 --> 00:11:46,605
I'M GOING TO TYPE I MORE, WHICH

329
00:11:46,672 --> 00:11:53,546
IS MILL TARRI MILITARISTIC HYPE,

330
00:11:53,612 --> 00:11:55,915
BECAUSE I THINK THAT THAT'S ONE

331
00:11:55,981 --> 00:11:57,783
FORM OF INSTITUTIONAL POWER THAT

332
00:11:57,850 --> 00:12:01,153
CAN GET UNDER THE SKIN IN

333
00:12:01,220 --> 00:12:03,355
NEIGHBORHOODS FOR INDIVIDUALS

334
00:12:03,422 --> 00:12:04,857
AND TARGETS PEOPLE FROM

335
00:12:04,924 --> 00:12:06,659
MINORITIZED GROUPS.

336
00:12:06,725 --> 00:12:08,360
THE OTHER THING TO KEEP IN MIND

337
00:12:08,427 --> 00:12:11,764
IS THAT OUR EXPERIENCES OF THESE

338
00:12:11,831 --> 00:12:12,865
SOCIAL FORCES AND STRUCTURAL

339
00:12:12,932 --> 00:12:14,400
FORCES REALLY CHANGES DEPENDING

340
00:12:14,467 --> 00:12:16,602
ON WHEN WE'RE HERE ON EARTH.

341
00:12:16,669 --> 00:12:17,903
BIRTH YEAR IS A FACTOR AND

342
00:12:17,970 --> 00:12:21,774
THAT'S ACTUALLY ONE OF THE

343
00:12:21,841 --> 00:12:23,576
WONDERFUL DESIGN ASPECTS OF

344
00:12:23,642 --> 00:12:24,443
STUDIES LIKE THE HEALTH AND

345
00:12:24,510 --> 00:12:25,778
RETIREMENT STUDY, WHERE WE CAN

346
00:12:25,845 --> 00:12:28,447
LOOK AT DIFFERENT BIRTH YEARS

347
00:12:28,514 --> 00:12:31,217
AND DIFFERENT WAVES OVER TIME.

348
00:12:31,283 --> 00:12:31,684
OKAY.

349
00:12:31,750 --> 00:12:34,286
AND THEN THE RED ARROWS ARE

350
00:12:34,353 --> 00:12:37,590
REALLY CONOTING THAT RISK AND

351
00:12:37,656 --> 00:12:39,125
RESILIENCE FACTORS AND SOCIAL

352
00:12:39,191 --> 00:12:41,527
DETERMINANTS ACROSS THE LIFE

353
00:12:41,594 --> 00:12:42,761
COURSE COULD PLAY A PART IN

354
00:12:42,828 --> 00:12:45,364
COGNITIVE RESERVE, OR COGNITIVE

355
00:12:45,431 --> 00:12:46,999
RESILIENCE, SO THAT GAP BETWEEN

356
00:12:47,066 --> 00:12:48,968
THE LEVEL OF PATHOLOGY IN THE

357
00:12:49,034 --> 00:12:52,071
BRAIN AND THE EXPERIENCE OF

358
00:12:52,138 --> 00:12:56,075
COGNITIVE FUNCTION, DYSFUNCTION.

359
00:12:56,142 --> 00:12:58,477
SO THE FIRST QUESTION, ONCE WE

360
00:12:58,544 --> 00:13:00,779
DECIDE WE WANT TO INTERROGATE

361
00:13:00,846 --> 00:13:02,715
THIS LIFE COURSE MODEL OF SOCIAL

362
00:13:02,781 --> 00:13:04,150
AND STRUCTURAL FACTORS AS THEY

363
00:13:04,216 --> 00:13:06,452
RELATE TO ADRDs, WHO SHOULD WE

364
00:13:06,519 --> 00:13:08,754
STUDY?

365
00:13:08,821 --> 00:13:09,955
AND I'M GOING TO TALK ABOUT THAT

366
00:13:10,022 --> 00:13:11,924
FOR A BIT.

367
00:13:11,991 --> 00:13:13,893
SO THIS IS A MAP.

368
00:13:13,959 --> 00:13:17,663
IT'S A LITTLE BIT OLDER, BUT

369
00:13:17,730 --> 00:13:20,232
IT'S STILL PROBABLY ROUGHLY

370
00:13:20,299 --> 00:13:21,767
ACCURATE THAT SHOWS THE OVERLAP

371
00:13:21,834 --> 00:13:24,670
BETWEEN COUNTY LEVEL PREVALENCE

372
00:13:24,737 --> 00:13:27,573
OF ALZHEIMER'S DISEASE AND

373
00:13:27,640 --> 00:13:29,108
NIA-FUNDED ADRD CENTERS.

374
00:13:29,175 --> 00:13:32,978
SO YOU CAN SEE THAT THERE ARE

375
00:13:33,045 --> 00:13:34,346
SOME BIG LOCATION GAPS,

376
00:13:34,413 --> 00:13:35,447
ESPECIALLY IN THE DEEP SOUTH, SO

377
00:13:35,514 --> 00:13:37,082
LOOKING FOR COLLABORATORS IN THE

378
00:13:37,149 --> 00:13:38,150
DEEP SOUTH THAT ARE ALZHEIMER'S

379
00:13:38,217 --> 00:13:39,385
DISEASE RESEARCH CENTERS IS

380
00:13:39,451 --> 00:13:43,622
ACTUALLY VERY DIFFICULT.

381
00:13:43,689 --> 00:13:45,724
AND SO I THINK THAT IN PART, WHO

382
00:13:45,791 --> 00:13:49,128
WE STUDY DEPENDS ON WHERE WE'RE

383
00:13:49,195 --> 00:13:51,530
AT, AND WE NEED TO BE AT THOSE

384
00:13:51,597 --> 00:13:52,932
PLACES WHERE PEOPLE WITH

385
00:13:52,998 --> 00:13:54,033
ALZHEIMER'S DISEASE ARE.

386
00:13:54,099 --> 00:13:55,467
AND THAT'S ESSENTIALLY WHAT I'M

387
00:13:55,534 --> 00:13:59,405
TRYING TO SAY WITH THIS GRAPH.

388
00:13:59,471 --> 00:14:02,341
THE OTHER THING THAT COMES UP IS

389
00:14:02,408 --> 00:14:04,843
SELECTION BIAS, AND WE WERE JUST

390
00:14:04,910 --> 00:14:07,613
CHATTING BEFORE THE TALK ABOUT

391
00:14:07,680 --> 00:14:10,783
THE RECENT STUDY THAT WAS BASED

392
00:14:10,849 --> 00:14:12,384
IN NACC LOOKING AT PEOPLE WITH

393
00:14:12,451 --> 00:14:15,688
TWO COPIES OF THE APOE4 ALLELE,

394
00:14:15,754 --> 00:14:17,022
AND IT JUST IMMEDIATELY MADE ME

395
00:14:17,089 --> 00:14:19,992
THINK OF THIS PAPER BY MIGUEL

396
00:14:20,059 --> 00:14:25,297
ARCE, WHO COMPARED THE

397
00:14:25,364 --> 00:14:27,600
DEMOGRAPHICS OF PEOPLE IN THE

398
00:14:27,666 --> 00:14:29,501
NACC STUDY WITH THE DEMOGRAPHICS

399
00:14:29,568 --> 00:14:30,736
OF THE PEOPLE IN THE HEALTH AND

400
00:14:30,803 --> 00:14:32,204
RETIREMENT STUDY, WHICH IS

401
00:14:32,271 --> 00:14:32,972
POPULATION-BASED.

402
00:14:33,038 --> 00:14:36,575
AND THIS IS A FIRST STEP IN THEN

403
00:14:36,642 --> 00:14:39,845
BEING ABLE TO TRANSPORT FINDINGS

404
00:14:39,912 --> 00:14:44,683
THAT YOU HAVE SHOWN IN NACC TO A

405
00:14:44,750 --> 00:14:47,786
POPULATION-BASED COHORT.

406
00:14:47,853 --> 00:14:49,755
AND YOU DO THAT BY CREATING

407
00:14:49,822 --> 00:14:51,390
WEIGHTS FOR EACH INDIVIDUAL IN

408
00:14:51,457 --> 00:14:55,995
THE HRS DEPENDING ON HOW THEY

409
00:14:56,061 --> 00:15:00,599
ARE REPRESENTED -- SORRY,

410
00:15:00,666 --> 00:15:01,800
WEIGHTS FOR PEOPLE IN NACC

411
00:15:01,867 --> 00:15:03,002
DEPENDING ON HOW THEY ARE

412
00:15:03,068 --> 00:15:04,103
REPRESENTED IN THE HRS.

413
00:15:04,169 --> 00:15:05,838
SO ESSENTIALLY THIS FIRST STEP

414
00:15:05,904 --> 00:15:08,574
IS LOOKING AT COVARIATE BALANCE,

415
00:15:08,641 --> 00:15:10,109
AND THEN THOSE DASHED LINES OR

416
00:15:10,175 --> 00:15:11,543
THE STANDARD MEAN DIFFERENCE

417
00:15:11,610 --> 00:15:13,178
BETWEEN THE NACC AND THE HEALTH

418
00:15:13,245 --> 00:15:15,247
AND RETIREMENT STUDY, AND WHAT

419
00:15:15,314 --> 00:15:16,649
MIGUEL FOUND WAS THAT NACC

420
00:15:16,715 --> 00:15:18,317
PARTICIPANTS ARE OLDER, THEY HAD

421
00:15:18,384 --> 00:15:21,253
MORE SCHOOLING, THEY HAVE WORSE

422
00:15:21,320 --> 00:15:24,857
SUBJECTIVE MEMORY, AND WORSE

423
00:15:24,923 --> 00:15:27,359
HEARING, BUT THEY ENDORSED FEWER

424
00:15:27,426 --> 00:15:28,794
DEPRESSIVE SYMPTOMS COMPARED TO

425
00:15:28,861 --> 00:15:32,231
HRS PARTICIPANTS.

426
00:15:32,298 --> 00:15:34,266
AND THOSE DIFFERENCES IN AGE,

427
00:15:34,333 --> 00:15:35,301
DEPRESSIVE SYMPTOMS AND HEARING

428
00:15:35,367 --> 00:15:36,902
DIFFICULTIES WERE LARGER AMONG

429
00:15:36,969 --> 00:15:39,938
THE LATINX AND NON-LATINX BLACK

430
00:15:40,005 --> 00:15:41,707
PARTICIPANTS COMPARED TO THE

431
00:15:41,774 --> 00:15:43,242
NON-LATINX WHITE PARTICIPANTS.

432
00:15:43,309 --> 00:15:45,210
SO THIS IS JUST TO SAY, AND IT'S

433
00:15:45,277 --> 00:15:46,078
PROBABLY TOO SMALL FOR THOSE OF

434
00:15:46,145 --> 00:15:48,047
YOU IN THE ROOM, HOPEFULLY NOT

435
00:15:48,113 --> 00:15:49,481
ONLINE, BUT YOU CAN SEE IN ONE

436
00:15:49,548 --> 00:15:51,984
OF THE TABLES THAT MIGUEL HAS IN

437
00:15:52,051 --> 00:15:56,255
THE PAPER THAT THE OVERALL

438
00:15:56,322 --> 00:15:58,023
REPRESENTATION OF BLACK AND

439
00:15:58,090 --> 00:15:59,425
LATINX PEOPLE IN NACC IS PRETTY

440
00:15:59,491 --> 00:16:01,060
GOOD.

441
00:16:01,126 --> 00:16:02,161
IT'S ESSENTIALLY MATCHING THAT

442
00:16:02,227 --> 00:16:04,029
OF THE HRS.

443
00:16:04,096 --> 00:16:06,198
BUT JUST BECAUSE THE COMPOSITION

444
00:16:06,265 --> 00:16:09,368
OF A SAMPLE MAY MATCH THE

445
00:16:09,435 --> 00:16:10,169
NATIONAL POPULATION, IT DOESN'T

446
00:16:10,235 --> 00:16:13,439
MEAN THAT THOSE PARTICIPANTS ARE

447
00:16:13,505 --> 00:16:14,306
REPRESENTATIVE OF THE NATIONAL

448
00:16:14,373 --> 00:16:16,375
POPULATION.

449
00:16:16,442 --> 00:16:17,810
AND IT'S ESPECIALLY PROBLEMATIC

450
00:16:17,876 --> 00:16:19,978
WHEN WE HAVE THOSE INTERACTIONS

451
00:16:20,045 --> 00:16:23,482
BETWEEN THE DEMOGRAPHIC FACTORS

452
00:16:23,549 --> 00:16:26,118
AND RACE/ETHNICITY IF WE'RE

453
00:16:26,185 --> 00:16:27,419
GOING TO BE MAKING CONCLUSIONS

454
00:16:27,486 --> 00:16:28,520
ABOUT RACIAL AND ETHNIC

455
00:16:28,587 --> 00:16:28,854
DIFFERENCES.

456
00:16:28,921 --> 00:16:30,055
AND THIS COMES INTO PLAY WITH

457
00:16:30,122 --> 00:16:32,925
TRIALS AS WELL.

458
00:16:32,991 --> 00:16:36,628
SO THIS IS A PAPER BY CASEY

459
00:16:36,695 --> 00:16:38,163
DIETE RS WHO LOOKED AT THE

460
00:16:38,230 --> 00:16:39,932
A4 TRIAL AND THIS TABLE IS

461
00:16:39,998 --> 00:16:42,401
BURIED IN THE SUPPLEMENT BUT ALL

462
00:16:42,468 --> 00:16:43,969
OF YOU SHOULD LOOK AT IT AND IT

463
00:16:44,036 --> 00:16:48,974
SHOWS THAT SHE TRACES BLACK

464
00:16:49,041 --> 00:16:50,776
VOLUNTEERS FOR THE A4 TRIAL

465
00:16:50,843 --> 00:16:52,144
THROUGH THE SCREENING PROCESS.

466
00:16:52,211 --> 00:16:54,012
AT THE FIRST STAGE, THEY HAD TO

467
00:16:54,079 --> 00:16:56,648
UNDERGO COGNITIVE TESTING AND A

468
00:16:56,715 --> 00:17:00,018
CDR, SO BLACK PARTICIPANTS IN

469
00:17:00,085 --> 00:17:02,221
THE A4 TRIAL WERE MORE LIKELY

470
00:17:02,287 --> 00:17:04,289
THAN WHITE PARTICIPANTS TO HAVE

471
00:17:04,356 --> 00:17:06,458
CDR SCORES ABOVE ZERO, WHICH WAS

472
00:17:06,525 --> 00:17:07,893
A REQUIREMENT TO HAVE A CDR

473
00:17:07,960 --> 00:17:10,362
SCORE OF ZERO FOR THE A4, AND

474
00:17:10,429 --> 00:17:14,233
THEY ALSO HAD LOWER MENTAL AND

475
00:17:14,299 --> 00:17:15,534
LOGICAL SCORES FOR WHITE

476
00:17:15,601 --> 00:17:16,435
PARTICIPANTS AND MORE LIKELY TO

477
00:17:16,502 --> 00:17:21,039
BE SCREENED OUT AT THAT FIRST

478
00:17:21,106 --> 00:17:24,309
STAGE THAN THE WHITE

479
00:17:24,376 --> 00:17:24,643
PARTICIPANTS.

480
00:17:24,710 --> 00:17:25,711
THEN AT THE SECOND STAGE, THE

481
00:17:25,778 --> 00:17:27,146
PEOPLE WHO GOT THROUGH

482
00:17:27,212 --> 00:17:29,114
REGARDLESS OF RACE DID AN

483
00:17:29,181 --> 00:17:30,315
AMYLOID SCAN, AND IF THEY

484
00:17:30,382 --> 00:17:33,986
WEREN'T A AMYLOID-POSITIVE, THEY

485
00:17:34,052 --> 00:17:35,387
COULD NOT BE PART OF THE TRIAL.

486
00:17:35,454 --> 00:17:37,322
AS IT TURNS OUT, BLACK AND ASIAN

487
00:17:37,389 --> 00:17:38,157
PARTICIPANTS WERE MORE LIKELY TO

488
00:17:38,223 --> 00:17:40,058
BE SCREENED OUT AT THAT STAGE AS

489
00:17:40,125 --> 00:17:42,027
WELL SO THEY WERE LESS LIKELY TO

490
00:17:42,094 --> 00:17:44,430
HAVE AMYLOID AT THAT SECOND

491
00:17:44,496 --> 00:17:47,366
STAGE.

492
00:17:47,433 --> 00:17:50,869
AND SO THERE'S ONE PIECE OF

493
00:17:50,936 --> 00:17:54,573
EVIDENCE THAT UP UNTIL LAST WEEK

494
00:17:54,640 --> 00:17:57,009
I WAS SAYING, WELL THIS IS

495
00:17:57,075 --> 00:17:58,744
BECAUSE YOU'RE SCREENING OUT

496
00:17:58,811 --> 00:18:01,947
PEOPLE BASED ON THE COGNITIVE

497
00:18:02,014 --> 00:18:05,317
TEST, WHICH IS BIASED, AND THEN

498
00:18:05,384 --> 00:18:08,053
YOU ARE TRYING TO LOOK FOR

499
00:18:08,120 --> 00:18:08,921
AMYLOID BUT YOU'VE ALREADY

500
00:18:08,987 --> 00:18:09,822
SCREENED OUT ALL THE BLACK

501
00:18:09,888 --> 00:18:11,557
PEOPLE WITH AMYLOID BECAUSE YOU

502
00:18:11,623 --> 00:18:13,959
MADE THEM PERFORM MUCH BETTER

503
00:18:14,026 --> 00:18:15,828
THAN THE POPULATION OF BLACK

504
00:18:15,894 --> 00:18:17,463
PEOPLE DOES ON THESE BIASED

505
00:18:17,529 --> 00:18:19,731
TESTS.

506
00:18:19,798 --> 00:18:21,533
AND SO THAT MADE SENSE TO ME

507
00:18:21,600 --> 00:18:24,336
UNTIL I LOOKED AT THIS STUDY,

508
00:18:24,403 --> 00:18:26,872
WHICH CAME OUT IN APRIL.

509
00:18:26,939 --> 00:18:31,310
IN THIS STUDY, THEY POOLED FOUR

510
00:18:31,376 --> 00:18:32,744
DIFFERENT TRIALS THAT THE FIRST

511
00:18:32,811 --> 00:18:35,747
SCREENING METHOD WAS BASICALLY

512
00:18:35,814 --> 00:18:37,683
PLASMA A BETA LEVELS.

513
00:18:37,749 --> 00:18:41,520
IF YOU HAD A HIGH PLASMA A BETA

514
00:18:41,587 --> 00:18:44,156
LEVEL, THEN YOU COULD GO ON AND

515
00:18:44,223 --> 00:18:47,659
GET YOUR PET SCAN.

516
00:18:47,726 --> 00:18:55,634
AND THIS IS DORIS MOLINA HENRY,

517
00:18:55,701 --> 00:18:57,936
BUT ESSENTIALLY THE FIGURE SHOWS

518
00:18:58,003 --> 00:18:59,571
THE PROPORTION OF PLASMA

519
00:18:59,638 --> 00:19:00,906
BIOMARKER ELIGIBLE PEOPLE BY

520
00:19:00,973 --> 00:19:03,075
RACE AND ETHNIC GROUP, AND THE

521
00:19:03,141 --> 00:19:04,142
RESULTS WERE ACTUALLY VERY

522
00:19:04,209 --> 00:19:05,911
SIMILAR TO CASEY'S RESULTS, THAT

523
00:19:05,978 --> 00:19:08,380
PEOPLE OF HISPANIC ETHNICITY OR

524
00:19:08,447 --> 00:19:09,848
BLACK OR ASIAN RACE WERE LESS

525
00:19:09,915 --> 00:19:12,150
LIKELY TO QUALIFY FOR THE

526
00:19:12,217 --> 00:19:14,620
TREATMENTS BASED ON THAT PLASMA

527
00:19:14,686 --> 00:19:15,521
BIOMARKER BEFORE THEY EVEN DID

528
00:19:15,587 --> 00:19:19,358
ANY COGNITIVE TESTING, AND

529
00:19:19,424 --> 00:19:20,559
THE -- BUT THE UNDERLYING REASON

530
00:19:20,626 --> 00:19:22,194
THAT THE AUTHOR CITED FOR THIS

531
00:19:22,261 --> 00:19:23,862
WAS THAT THESE GROUPS HAVE LOWER

532
00:19:23,929 --> 00:19:25,864
RATES OF BIOMARKER CONFIRMED

533
00:19:25,931 --> 00:19:29,535
ALZHEIMER'S DISEASE.

534
00:19:29,601 --> 00:19:31,403
SO THIS IS AMONG SEVERAL NOW

535
00:19:31,470 --> 00:19:34,773
RESULTS COMING OUT FROM MULTIPLE

536
00:19:34,840 --> 00:19:37,643
COHORTS, AND PEOPLE ARE STARTING

537
00:19:37,709 --> 00:19:39,311
TO SUGGEST THAT THE DIAGNOSIS OF

538
00:19:39,378 --> 00:19:40,679
ALZHEIMER'S DISEASE SHOULD RELY

539
00:19:40,746 --> 00:19:44,082
ON MAYBE DIFFERENT CUT POINTS BY

540
00:19:44,149 --> 00:19:46,051
RACE IN TERMS OF BIOMARKERS, AND

541
00:19:46,118 --> 00:19:46,952
THAT DIFFERENT THERAPIES WILL

542
00:19:47,019 --> 00:19:49,254
HAVE TO BE DEVELOPED FOR

543
00:19:49,321 --> 00:19:50,422
NON-WHITE PEOPLE.

544
00:19:50,489 --> 00:19:53,158
BUT I GUESS I WANT TO -- I WANT

545
00:19:53,225 --> 00:19:56,562
TO KNOW WHETHER SELECTION BIAS

546
00:19:56,628 --> 00:19:57,763
COULD AFFECT THESE RESULTS AS

547
00:19:57,829 --> 00:20:03,635
WELL.

548
00:20:03,702 --> 00:20:05,003
SO I'M GOING TO BRING YOU NOW

549
00:20:05,070 --> 00:20:06,171
INTO SOME STUDIES I'VE BEEN

550
00:20:06,238 --> 00:20:07,306
WORKING ON FOR A REALLY LONG

551
00:20:07,372 --> 00:20:08,473
TIME TO KIND OF INTERROGATE

552
00:20:08,540 --> 00:20:09,274
THIS.

553
00:20:09,341 --> 00:20:13,178
SO THIS IS THE WHITE CAP STUDY,

554
00:20:13,245 --> 00:20:16,448
THE WASHINGTON HEIGHTS, HAMILTON

555
00:20:16,515 --> 00:20:18,216
HEIGHTS, INWOOD COLUMBIA AGING

556
00:20:18,283 --> 00:20:19,851
PROJECT THAT'S BEEN GOING ON

557
00:20:19,918 --> 00:20:21,286
SINCE 1992, AND IT'S A COHORT OF

558
00:20:21,353 --> 00:20:22,988
PEOPLE WHO ARE MEDICARE-ELIGIBLE

559
00:20:23,055 --> 00:20:25,324
WHO LIVE IN THE CENSUS TRACTS

560
00:20:25,390 --> 00:20:26,625
AROUND THE COLUMBIA MEDICAL

561
00:20:26,692 --> 00:20:29,695
CENTER IN NORTHERN MANHATTAN.

562
00:20:29,761 --> 00:20:32,431
OVER 6,500 PEOPLE HAVE

563
00:20:32,497 --> 00:20:33,532
PARTICIPATED AND WE VISIT THEM

564
00:20:33,599 --> 00:20:35,200
IN THEIR HOME TO DO A WORKUP, SO

565
00:20:35,267 --> 00:20:36,468
THEY GET NEUROPSYCH TESTING,

566
00:20:36,535 --> 00:20:39,504
THEY GET MEDICAL EVALUATION,

567
00:20:39,571 --> 00:20:41,473
BLOOD, MANY OF THEM COME IN TO

568
00:20:41,540 --> 00:20:45,677
THE MEDICAL CENTER TO GET MRI,

569
00:20:45,744 --> 00:20:47,946
AND CENSUS RECORDS SHOW US THAT

570
00:20:48,013 --> 00:20:51,883
THIS COHORT IS REPRESENTATIVE OF

571
00:20:51,950 --> 00:20:53,318
OLDER ADULTS WHO LIVE IN THESE

572
00:20:53,385 --> 00:20:54,386
NEIGHBORHOODS.

573
00:20:54,453 --> 00:20:58,790
SO WE ARE RIGHT ON IN TERMS OF

574
00:20:58,857 --> 00:20:59,691
RACE/ETHNICITY, IN TERMS OF

575
00:20:59,758 --> 00:21:00,859
EDUCATION, IN TERMS OF LANGUAGE.

576
00:21:00,926 --> 00:21:03,929
ALL OF OUR -- THE PEOPLE ON OUR

577
00:21:03,996 --> 00:21:05,897
STAFF ARE BILINGUAL IN SPANISH

578
00:21:05,964 --> 00:21:07,399
AND ENGLISH, AND ALL OF THE

579
00:21:07,466 --> 00:21:09,167
MEASURES HAVE BEEN ADAPTED IN

580
00:21:09,234 --> 00:21:10,802
SPANISH AND ENGLISH, AND USED

581
00:21:10,869 --> 00:21:12,471
FOR MANY YEARS, AND IT'S A

582
00:21:12,537 --> 00:21:15,874
LONGITUDAL COHORT.

583
00:21:15,941 --> 00:21:17,909
AND WHEN PLASMA BIOMARKERS FIRST

584
00:21:17,976 --> 00:21:20,979
CAME ALONG, THEY WERE SENT OUT

585
00:21:21,046 --> 00:21:22,714
FOR ANALYSIS AND THE QUESTION

586
00:21:22,781 --> 00:21:25,450
COULD BE ASKED FIRST, HOW WELL

587
00:21:25,517 --> 00:21:27,853
CAN THESE BLOOD-BASED PLASMA

588
00:21:27,919 --> 00:21:28,854
BIOMARKERS DISTINGUISH BETWEEN

589
00:21:28,920 --> 00:21:30,589
THOSE WITH AND WITHOUT A

590
00:21:30,656 --> 00:21:32,991
CLINICAL DIAGNOSIS OF DEMENTIA

591
00:21:33,058 --> 00:21:35,093
IN WHICAP, AND ALSO ARE THERE

592
00:21:35,160 --> 00:21:37,195
RACIAL AND ETHNIC DIFFERENCES IN

593
00:21:37,262 --> 00:21:39,131
THE LEVELS OF THESE PLASMA

594
00:21:39,197 --> 00:21:40,332
BIOMARKERS.

595
00:21:40,399 --> 00:21:41,299
SO FIRST THING TO TELL YOU IS

596
00:21:41,366 --> 00:21:44,169
THAT THE LEVELS OF AMYLOID TAU

597
00:21:44,236 --> 00:21:46,905
AND NFL WERE NOT RELIABLY

598
00:21:46,972 --> 00:21:49,174
DIFFERENT IN WHICAP ACROSS

599
00:21:49,241 --> 00:21:50,509
RACE/ETHNICITY, SO WE ARE NOT

600
00:21:50,575 --> 00:21:52,277
REPLICATING THE MOLINA-HENRY

601
00:21:52,344 --> 00:21:54,112
PAPER.

602
00:21:54,179 --> 00:21:57,649
AND THE BIOMARKER JUST FOR YOU

603
00:21:57,716 --> 00:22:00,485
TO LOG, THE BIOMARKER THAT BEST

604
00:22:00,552 --> 00:22:02,654
DISTINGUISHED BETWEEN THOSE WHO

605
00:22:02,721 --> 00:22:04,856
HAD A CLINICAL DIAGNOSIS OF

606
00:22:04,923 --> 00:22:09,528
ALZHEIMER'S DISEASE VERSUS --

607
00:22:09,594 --> 00:22:11,830
YOU CAN SEE FROM THOSE AREAS

608
00:22:11,897 --> 00:22:13,031
UNDER THE CURVE, THE CONDITION

609
00:22:13,098 --> 00:22:15,634
FOR EACH BIOMARKER WAS CERTAINLY

610
00:22:15,701 --> 00:22:17,302
NOT AS GOOD AS YOU WILL FIND IN

611
00:22:17,369 --> 00:22:18,837
CLINIC-BASED SAMPLES, THIS IS A

612
00:22:18,904 --> 00:22:20,038
COMMUNITY-BASED SAMPLE, BUT ALL

613
00:22:20,105 --> 00:22:23,241
MARKERS TAKEN TOGETHER HAD AN, I

614
00:22:23,308 --> 00:22:23,875
GUESS, RELATIVELY DECENT AREA

615
00:22:23,942 --> 00:22:24,943
UNDER THE CURVE.

616
00:22:25,010 --> 00:22:27,646
AND HERE'S ANOTHER CHAPTER IN

617
00:22:27,713 --> 00:22:31,083
THE WHO TO STUDY SAGA WITH A

618
00:22:31,149 --> 00:22:32,284
BIOMARKER -- PLASMA BIOMARKER

619
00:22:32,350 --> 00:22:33,485
PLOT.

620
00:22:33,552 --> 00:22:35,454
AFTER 25 YEARS OF WORK IN

621
00:22:35,520 --> 00:22:36,988
WHICAP, WE REALIZED THAT

622
00:22:37,055 --> 00:22:38,323
STARTING RESEARCH PARTICIPATION

623
00:22:38,390 --> 00:22:40,726
AT AGE 65 IN THIS COHORT WAS WAY

624
00:22:40,792 --> 00:22:42,160
TOO LATE, THAT A LOT OF THE

625
00:22:42,227 --> 00:22:44,329
ACTION THAT HAD TO DO WITH RISK

626
00:22:44,396 --> 00:22:45,297
AND RESILIENCE HAD ALREADY

627
00:22:45,363 --> 00:22:47,699
HAPPENED IN MID LIFE, AND WE

628
00:22:47,766 --> 00:22:50,769
WERE ALREADY SEEING VERY HIGH

629
00:22:50,836 --> 00:22:53,271
LEVELS OF ESPECIALLY

630
00:22:53,338 --> 00:22:54,072
CEREBROVASCULAR DISEASE ON BRAIN

631
00:22:54,139 --> 00:22:57,776
SCANS.

632
00:22:57,843 --> 00:22:58,877
SO WE WERE INTERESTED IN

633
00:22:58,944 --> 00:23:00,412
CATCHING THOSE MECHANISMS EARLY

634
00:23:00,479 --> 00:23:02,380
AND STUDYING CRITICAL PERIODS IN

635
00:23:02,447 --> 00:23:05,517
THE COURSE OF ALZHEIMER'S

636
00:23:05,584 --> 00:23:07,285
DISEASE AMONG BLACK AND LATINX

637
00:23:07,352 --> 00:23:09,154
PEOPLE, IN PART BECAUSE OF

638
00:23:09,221 --> 00:23:10,222
ACCELERATED AGING AND ALSO

639
00:23:10,288 --> 00:23:13,291
DIFFERENTIAL SURVIVAL.

640
00:23:13,358 --> 00:23:16,027
SO DIFFERENCES AT RACIAL AND

641
00:23:16,094 --> 00:23:17,929
ETHNIC DIFFERENCES AT AGE 65 ARE

642
00:23:17,996 --> 00:23:19,097
REALLY AS WIDE AS THEY'RE GOING

643
00:23:19,164 --> 00:23:22,367
TO GET, BECAUSE OF DIFFERENTIAL

644
00:23:22,434 --> 00:23:27,739
SURVIVAL.

645
00:23:27,806 --> 00:23:28,940
SO THE SECOND REASON WHY WE

646
00:23:29,007 --> 00:23:31,243
WANTED TO START ANOTHER STUDY

647
00:23:31,309 --> 00:23:32,878
WAS THAT FEWER LARGE SCALE

648
00:23:32,944 --> 00:23:36,047
COHORT STUDIES HAD

649
00:23:36,114 --> 00:23:37,149
PERSPECTIVELY -- HAD

650
00:23:37,215 --> 00:23:38,884
PERSPECTIVELY COLLECTED DATA

651
00:23:38,950 --> 00:23:41,853
FROM BOTH PARENTS AND OFFSPRING

652
00:23:41,920 --> 00:23:43,288
GENERATIONS, AND MOST

653
00:23:43,355 --> 00:23:44,523
INTERGENERATIONAL RESEARCH ON

654
00:23:44,589 --> 00:23:45,891
ALZHEIMER'S DISEASE TO DATE HAD

655
00:23:45,957 --> 00:23:47,659
BEEN MOSTLY WHITE COHORTS.

656
00:23:47,726 --> 00:23:49,861
WELL EDUCATED COHORTS.

657
00:23:49,928 --> 00:23:51,496
SO WE WERE ABLE TO GET FUNDING

658
00:23:51,563 --> 00:23:56,201
FOR THE OFFSPRING COHORT, AND SO

659
00:23:56,268 --> 00:23:58,570
FAR WE'VE RECRUITED ABOUT 2,100

660
00:23:58,637 --> 00:24:00,238
ADULT CHILDREN OF THE WHICAP

661
00:24:00,305 --> 00:24:02,207
PARENTS.

662
00:24:02,274 --> 00:24:04,075
AND ARE STUDYING THEM

663
00:24:04,142 --> 00:24:04,810
LONGITUDALLY.

664
00:24:04,876 --> 00:24:07,979
WE HAVE DONE PLASMA BIOMARKER

665
00:24:08,046 --> 00:24:11,049
LEVELS AMONG THESE OFFSPRING AND

666
00:24:11,116 --> 00:24:12,884
THEIR MEAN AGE IS ABOUT 55.

667
00:24:12,951 --> 00:24:15,086
THERE ARE NO RACIAL AND ETHNIC

668
00:24:15,153 --> 00:24:18,356
DIFFERENCES IN AMYLOID, IN PTAU,

669
00:24:18,423 --> 00:24:21,660
IN NFL OR GFAP.

670
00:24:21,726 --> 00:24:23,528
SO AGAIN, WE'RE NOT REPLICATING

671
00:24:23,595 --> 00:24:27,232
THE PAPERS THAT ARE COMING OUT

672
00:24:27,299 --> 00:24:28,567
FROM CONVENIENCE SAMPLES OR

673
00:24:28,633 --> 00:24:29,434
CLINIC-BASED COHORT WITH RESPECT

674
00:24:29,501 --> 00:24:30,535
TO RACIAL AND ETHNIC

675
00:24:30,602 --> 00:24:30,969
DIFFERENCES.

676
00:24:31,036 --> 00:24:34,039
SO TO SUM UP THE RESULTS IN

677
00:24:34,105 --> 00:24:37,409
CONVENIENCE SAMPLES DO NOT

678
00:24:37,475 --> 00:24:38,743
GENERALIZE TO POPULATION

679
00:24:38,810 --> 00:24:39,077
SAMPLES.

680
00:24:39,144 --> 00:24:40,912
I SHOULD SAY WHAT'S NOT

681
00:24:40,979 --> 00:24:44,316
PUBLISHED YET ARE RESULTS FROM

682
00:24:44,382 --> 00:24:45,851
REGARDS, RESULTS FROM THE HEALTH

683
00:24:45,917 --> 00:24:47,118
AND RETIREMENT STUDY, THE

684
00:24:47,185 --> 00:24:48,053
RESULTS FROM THE HIGH SCHOOL AND

685
00:24:48,119 --> 00:24:49,354
BEYOND STUDY THAT ARE BASICALLY

686
00:24:49,421 --> 00:24:50,322
ESSENTIALLY THE SAME AS WHAT I'M

687
00:24:50,388 --> 00:24:52,424
SHOWING YOU WITH THE WHICAP AND

688
00:24:52,490 --> 00:24:56,127
OFFSPRING, NO DIFFERENCES ACROSS

689
00:24:56,194 --> 00:25:02,567
GROUPS, AND SO THUS FAR, I THINK

690
00:25:02,634 --> 00:25:04,436
THOSE CLINIC-BASED STUDIES CAN

691
00:25:04,502 --> 00:25:06,071
LEAD TO MISLEADING COP

692
00:25:06,137 --> 00:25:07,939
COLLUSIONS ABOUT IDENTIFIABLE

693
00:25:08,006 --> 00:25:09,207
RISK FOR ALZHEIMER'S DISEASE AND

694
00:25:09,274 --> 00:25:09,641
RELATED DEMENTIAS.

695
00:25:09,708 --> 00:25:11,710
I WANTED TO POINT OUT HERE ONE

696
00:25:11,776 --> 00:25:13,545
OF MY FAVORITE NEW STUDIES,

697
00:25:13,612 --> 00:25:15,814
WHICH IS THE ACHIEVE TRIAL, THE

698
00:25:15,881 --> 00:25:17,249
HEARING RANDOMIZATION TRIAL,

699
00:25:17,315 --> 00:25:19,184
WHERE THEY REALLY ONLY FOUND THE

700
00:25:19,251 --> 00:25:20,418
RESULTS IN THE COMMUNITY-BASED

701
00:25:20,485 --> 00:25:21,486
COHORT.

702
00:25:21,553 --> 00:25:24,556
AND SO GENERALIZATION IS THAT

703
00:25:24,623 --> 00:25:26,324
THERE DON'T BE A BETTER EXAMPLE

704
00:25:26,391 --> 00:25:28,493
OF HOW IMPORTANT IT IS TO HAVE

705
00:25:28,560 --> 00:25:33,298
REPRESENTATIVE COHORT.

706
00:25:33,365 --> 00:25:34,633
SO LET'S MOVE ON NOW, WE'VE

707
00:25:34,699 --> 00:25:36,034
TALKED ABOUT WHO WE'RE GOING TO

708
00:25:36,101 --> 00:25:36,935
STUDY, LET'S MOVE ON TO WHAT

709
00:25:37,002 --> 00:25:38,770
SHOULD WE MEASURE.

710
00:25:38,837 --> 00:25:40,305
EARLY IN MY CAREER, I WAS REALLY

711
00:25:40,372 --> 00:25:42,707
CONCERNED WITH COGNITIVE TEST

712
00:25:42,774 --> 00:25:43,608
BIAS.

713
00:25:43,675 --> 00:25:45,343
SOME MEASURES, LIKE

714
00:25:45,410 --> 00:25:47,779
LANGUAGE-BASED MEASURES OR

715
00:25:47,846 --> 00:25:48,947
REASONING-BASED MEASURES ARE

716
00:25:49,014 --> 00:25:51,783
MORE BIASED THAN MEASURES

717
00:25:51,850 --> 00:25:53,652
THAT -- LIKE A WORDLESS LEARNING

718
00:25:53,718 --> 00:25:55,420
TASK FOR PEOPLE WITH LOW

719
00:25:55,487 --> 00:25:59,024
LITERACY, FOR PEOPLE WITH A

720
00:25:59,090 --> 00:25:59,891
DIFFERENT EDUCATIONAL

721
00:25:59,958 --> 00:26:00,859
BACKGROUND, WITH PEOPLE WITH

722
00:26:00,926 --> 00:26:01,726
DIFFERENT CULTURAL BACKGROUNDS

723
00:26:01,793 --> 00:26:02,827
THAN THOSE WHO THE TESTS WERE

724
00:26:02,894 --> 00:26:05,463
ORIGINALLY DEVELOPED AND NORMED

725
00:26:05,530 --> 00:26:07,966
ON.

726
00:26:08,033 --> 00:26:09,034
I FOUND IN MY RESEARCH THAT

727
00:26:09,100 --> 00:26:10,068
FIRST THERE WERE NIECE

728
00:26:10,135 --> 00:26:11,369
DIFFERENCES ACROSS DOMAINS.

729
00:26:11,436 --> 00:26:13,038
THERE'S SOME DOMAINS WE COULD

730
00:26:13,104 --> 00:26:14,639
REALLY RELY ON, SOME TESTS WE

731
00:26:14,706 --> 00:26:15,874
COULD REALLY RELY ON TO BE

732
00:26:15,941 --> 00:26:16,942
ACCURATE REFLECTIONS OF

733
00:26:17,008 --> 00:26:18,376
COGNITION REGARDLESS OF LITERACY

734
00:26:18,443 --> 00:26:23,214
LEVEL, REGARDLESS OF EDUCATIONAL

735
00:26:23,281 --> 00:26:29,854
AND CULTURAL BACKGROUND.

736
00:26:29,921 --> 00:26:31,256
AND SOME WERE JUST BASICALLY NOT

737
00:26:31,323 --> 00:26:33,124
HELPFUL AT ALL IN MAKING A

738
00:26:33,191 --> 00:26:34,225
DISTINCTION BETWEEN COGNITIVE

739
00:26:34,292 --> 00:26:37,729
IMPAIRMENT, REAL COGNITIVE

740
00:26:37,796 --> 00:26:40,799
IMPAIRMENT, AND NORMAL

741
00:26:40,865 --> 00:26:42,067
COGNITION, NORMAL AGING.

742
00:26:42,133 --> 00:26:44,536
I ALSO FOUND THAT LONGITUDAL

743
00:26:44,602 --> 00:26:47,038
ASSESSMENT OR CHANGE OVER TIME

744
00:26:47,105 --> 00:26:50,408
AS AN OUT COME OUTCOME IN THESES

745
00:26:50,475 --> 00:26:52,944
WAS MUCH MORE -- LESS BIASED,

746
00:26:53,011 --> 00:26:54,813
LESS BIASED THAN INTERCEPT OR,

747
00:26:54,879 --> 00:26:57,282
YOU KNOW, PERFORMANCE AT ANY ONE

748
00:26:57,349 --> 00:27:02,687
CROSS-SECTION.

749
00:27:02,754 --> 00:27:03,455
TREMENDOUS ADVANCEMENTS HAVE

750
00:27:03,521 --> 00:27:05,056
HAPPENED IN NEUROPSYCH

751
00:27:05,123 --> 00:27:06,391
ASSESSMENT SINCE I STARTED OUT,

752
00:27:06,458 --> 00:27:09,794
AND IN ADDITION TO ADAPTIVE

753
00:27:09,861 --> 00:27:11,096
COGNITIVE MEASUREMENT SYSTEMS

754
00:27:11,162 --> 00:27:12,731
LIKE NIH TOOLBOX, WE HAVE MORE

755
00:27:12,797 --> 00:27:16,868
DATA ON THESE TRADITIONAL TASKS

756
00:27:16,935 --> 00:27:19,404
THAT HAVE BEEN ADAPTED ACROSS

757
00:27:19,471 --> 00:27:21,606
CONTEXT, LANGUAGE, AND

758
00:27:21,673 --> 00:27:23,341
HARMONIZED ACROSS COHORTS, SOME

759
00:27:23,408 --> 00:27:25,944
OF THEM HAVE BEEN HARMONIZED

760
00:27:26,011 --> 00:27:28,380
INTENTIONALLY, LIKE THE

761
00:27:28,446 --> 00:27:29,781
HEALTH -- LET ME SEE IF I CAN

762
00:27:29,848 --> 00:27:31,616
GET THIS RIGHT -- THE HARMONIZED

763
00:27:31,683 --> 00:27:33,518
COGNITIVE ASSESSMENT PROTOCOL.

764
00:27:33,585 --> 00:27:34,919
I ALMOST DID A JOHN KING THERE

765
00:27:34,986 --> 00:27:36,554
BECAUSE HE CALLS IT SOMETHING

766
00:27:36,621 --> 00:27:37,455
ELSE.

767
00:27:37,522 --> 00:27:38,790
AND ALSO THE HARMONIZATION MIGHT

768
00:27:38,857 --> 00:27:39,758
BE UNPLANNED, LIKE A RECENT

769
00:27:39,824 --> 00:27:41,259
EFFORT TO HARMONIZE ALL OF THE

770
00:27:41,326 --> 00:27:43,928
STUDIES INVOLVED IN THE C4R

771
00:27:43,995 --> 00:27:46,231
COLLABORATIVE COHORT.

772
00:27:46,297 --> 00:27:48,433
SO WHAT DOES IT REALLY MEAN TO

773
00:27:48,500 --> 00:27:48,700
HARMONIZE?

774
00:27:48,767 --> 00:27:51,803
I'M SHOWING YOU SOME OF THESE

775
00:27:51,870 --> 00:27:55,840
STARTING STEPS HERE, WHICH IS TO

776
00:27:55,907 --> 00:27:57,509
IDENTIFY UNIVERSAL DOMAINS OF

777
00:27:57,575 --> 00:28:00,111
COGNITION THAT ARE IMPORTANT TO

778
00:28:00,178 --> 00:28:02,847
COGNITION IN AGING, AND THEN

779
00:28:02,914 --> 00:28:04,382
REPRESENT THOSE WITH MULTIPLE

780
00:28:04,449 --> 00:28:05,250
DIFFERENT MEASURES.

781
00:28:05,316 --> 00:28:09,087
AND THAT'S KIND OF WHAT'S

782
00:28:09,154 --> 00:28:11,589
CLARIFIED IN THESE FACTOR

783
00:28:11,656 --> 00:28:14,659
ANALYSES, IN THESE CONFIRMATORY

784
00:28:14,726 --> 00:28:15,860
FACTOR ANALYSES THAT HAVE

785
00:28:15,927 --> 00:28:18,596
OCCURRED IN BOTH HALSI ON THE

786
00:28:18,663 --> 00:28:21,066
LEFT WITH LINDSAY KOBAYASHI,

787
00:28:21,132 --> 00:28:22,967
THAT'S A STUDY IN SOUTH AFRICA

788
00:28:23,034 --> 00:28:24,402
THAT'S ONE OF THE HCAP GLOBAL

789
00:28:24,469 --> 00:28:28,540
NETWORK STUDIES, AND THE U.S.

790
00:28:28,606 --> 00:28:29,974
HCAP, THAT'S RICH JONES' PAPER

791
00:28:30,041 --> 00:28:32,811
THERE ON THE RIGHT.

792
00:28:32,877 --> 00:28:34,579
SO I THINK IT'S BEEN A MAJOR

793
00:28:34,646 --> 00:28:35,780
ACHIEVEMENT TO FIND THESE

794
00:28:35,847 --> 00:28:37,615
BATTERIES OF TESTS THAT CAN BE

795
00:28:37,682 --> 00:28:40,118
ADAPTED ACROSS SETTINGS, ACROSS

796
00:28:40,185 --> 00:28:42,320
LIKE DRASTICALLY DIFFERENT

797
00:28:42,387 --> 00:28:45,290
SETTINGS TO MEASURE THESE

798
00:28:45,356 --> 00:28:46,825
DIFFERENT DOMAINS.

799
00:28:46,891 --> 00:28:48,226
BUT I DO JUST WANT TO REMIND YOU

800
00:28:48,293 --> 00:28:50,195
THAT WE NEED TO DO OUR DUE

801
00:28:50,261 --> 00:28:52,297
DILIGENCE, ESPECIALLY WHEN WE

802
00:28:52,363 --> 00:28:54,332
HARMONIZE, TO FIGURE OUT, TO

803
00:28:54,399 --> 00:28:55,567
SYSTEMATICALLY TEST WHETHER OUR

804
00:28:55,633 --> 00:28:58,870
MEASURES ARE INVARIANT ACROSS

805
00:28:58,937 --> 00:29:02,240
GROUPS AND SUBGROUPS, ACROSS

806
00:29:02,307 --> 00:29:05,844
RACE/ETHNICITY, LANGUAGE,

807
00:29:05,910 --> 00:29:07,045
THROUGHOUT MY CAREER, MY CONCERN

808
00:29:07,112 --> 00:29:10,014
ABOUT BIAS IN TESTING HAS REALLY

809
00:29:10,081 --> 00:29:15,386
EVOLVED TO WE NEED TO DO THIS

810
00:29:15,453 --> 00:29:17,322
STEP, TO LOOK FOR INVARIANTS

811
00:29:17,388 --> 00:29:18,423
ACROSS THESE DIFFERENT TESTS.

812
00:29:18,490 --> 00:29:23,761
AND WHAT JUSTINA ABALRIGER FOUND

813
00:29:23,828 --> 00:29:26,965
WAS THAT WHEN WE DID THAT ACROSS

814
00:29:27,031 --> 00:29:28,800
RACE/ETHNICITY, AGE, SEX, GENDER

815
00:29:28,867 --> 00:29:31,002
AND TIME OF MEASUREMENT, MEANING

816
00:29:31,069 --> 00:29:32,770
FIRST VISIT, SECOND VISIT, AND

817
00:29:32,837 --> 00:29:35,039
SO ON, THAT SOME OF OUR TESTS

818
00:29:35,106 --> 00:29:38,309
NEEDED TO GET THROWN OUT BECAUSE

819
00:29:38,376 --> 00:29:39,844
THEY HAD METRIC -- BECAUSE THEY

820
00:29:39,911 --> 00:29:44,115
DID NOT HAVE INVARIANTS, METRIC

821
00:29:44,182 --> 00:29:44,983
INVARIANCE ACROSS THESE

822
00:29:45,049 --> 00:29:46,317
DIFFERENT GROUPS, AND SO IF WE

823
00:29:46,384 --> 00:29:51,556
WERE TO CREATE A FACTOR SCORE

824
00:29:51,623 --> 00:29:53,324
THAT INCLUDED THOSE TESTS, IT

825
00:29:53,391 --> 00:29:54,492
WOULD INTRODUCE BIAS ACROSS

826
00:29:54,559 --> 00:29:55,059
DIFFERENT GROUPS.

827
00:29:55,126 --> 00:29:56,394
AND SO NOW THESE ARE THE TOOLS,

828
00:29:56,461 --> 00:29:59,330
THESE ARE THE PSYCHOMETRIC TOOLS

829
00:29:59,397 --> 00:30:02,066
THAT WE HAVE TO ADDRESS THESE

830
00:30:02,133 --> 00:30:09,274
MEASUREMENT PROBLEMS.

831
00:30:09,340 --> 00:30:10,275
LET'S SAY YOU'RE IN THE AUDIENCE

832
00:30:10,341 --> 00:30:12,644
AND AWR LIKE, JEN, I DON'T CARE

833
00:30:12,710 --> 00:30:13,778
ABOUT COGNITIVE TESTING, I JUST

834
00:30:13,845 --> 00:30:15,547
WANT TO KNOW WHO HAS DEMENTIA

835
00:30:15,613 --> 00:30:18,349
AND WHO HAS MCI.

836
00:30:18,416 --> 00:30:18,950
THOSE CLASSIFICATIONS, THEY'RE

837
00:30:19,017 --> 00:30:20,118
NOT BIASED BECAUSE THEY HAVE --

838
00:30:20,185 --> 00:30:21,786
HE YES, THEY HAVE A COGNITIVE

839
00:30:21,853 --> 00:30:22,987
COMPONENT, BUT THEY ALSO HAVE A

840
00:30:23,054 --> 00:30:23,755
FUNCTIONAL COMPONENT, AND THAT'S

841
00:30:23,821 --> 00:30:28,059
REAL.

842
00:30:28,126 --> 00:30:30,795
SO THEY'RE TOO MESSY, GIVE ME

843
00:30:30,862 --> 00:30:32,864
THE ADJUDICATED DEMENTIA STATUS.

844
00:30:32,931 --> 00:30:34,165
AND THAT'S WHAT MIGUEL DID WHEN

845
00:30:34,232 --> 00:30:37,235
HE LOOKED AT, IN THE WHICAP

846
00:30:37,302 --> 00:30:39,370
COHORT, WHETHER ILLITERATE

847
00:30:39,437 --> 00:30:42,607
PEOPLE ARE AT HIGHER RISK FOR

848
00:30:42,674 --> 00:30:44,676
INCIDENT CASES OF ALZHEIMER'S

849
00:30:44,742 --> 00:30:45,543
DISEASE COMPARED TO LITERATE

850
00:30:45,610 --> 00:30:46,945
PEOPLE.

851
00:30:47,011 --> 00:30:48,479
ALL OF THESE PEOPLE HAD

852
00:30:48,546 --> 00:30:49,914
ESSENTIALLY NO FORMAL EDUCATION,

853
00:30:49,981 --> 00:30:52,050
SO THAT'S SOMETHING VERY UNIQUE

854
00:30:52,116 --> 00:30:53,451
ABOUT THE WHICAP COHORT, IS THAT

855
00:30:53,518 --> 00:30:54,953
THERE'S SOME PEOPLE WHO KNOW HOW

856
00:30:55,019 --> 00:30:55,720
TO READ AND WRITE BECAUSE THEY

857
00:30:55,787 --> 00:30:57,121
WERE TAUGHT BY THEIR OLDER

858
00:30:57,188 --> 00:31:00,091
SIBLINGS OR THEY ESSENTIALLY HAD

859
00:31:00,158 --> 00:31:01,960
SOME -- A LITTLE BIT OF HOME,

860
00:31:02,026 --> 00:31:03,628
YOU KNOW, EDUCATION, BUT THEY

861
00:31:03,695 --> 00:31:08,066
NEVER HAD FORMAL SCHOOLING.

862
00:31:08,132 --> 00:31:10,235
AND MOST OF THEM ARE ILLITERATE

863
00:31:10,301 --> 00:31:12,770
IN THE WHICAP COHORT, BUT THIS

864
00:31:12,837 --> 00:31:15,607
THEREARE A GROUP OF PEOPLE THATE

865
00:31:15,673 --> 00:31:16,107
LITERACY SKILLS.

866
00:31:16,174 --> 00:31:17,175
THEY'RE NOT LIKE THE TOP READERS

867
00:31:17,242 --> 00:31:19,877
BUT THEY HAVE TOP LITERACY

868
00:31:19,944 --> 00:31:20,211
SKILLS.

869
00:31:20,278 --> 00:31:23,281
AND WHAT MIGUEL AND GLORIA FELIX

870
00:31:23,348 --> 00:31:24,816
FOUND WAS THAT LITERACY, JUST

871
00:31:24,882 --> 00:31:27,885
INDEPENDENT FROM EDUCATIONAL

872
00:31:27,952 --> 00:31:31,923
EXPOSURE, SCHOOLING, PROTECTED

873
00:31:31,990 --> 00:31:33,491
PEOPLE AGAINST INCIDENT

874
00:31:33,558 --> 00:31:35,627
ALZHEIMER'S DISEASE.

875
00:31:35,693 --> 00:31:37,729
BUT WHEN YOU LOOK AT THE

876
00:31:37,795 --> 00:31:38,596
COGNITIVE TEST SCORES OVER TIME,

877
00:31:38,663 --> 00:31:41,232
THIS IS WHAT YOU SEE.

878
00:31:41,299 --> 00:31:42,867
THERE IS NO DIFFERENCE IN THE

879
00:31:42,934 --> 00:31:43,968
SLOPE HERE WHATSOEVER.

880
00:31:44,035 --> 00:31:47,105
YOU CAN SEE THE ILLITERATE FOLKS

881
00:31:47,171 --> 00:31:50,074
ARE STARTING AT A LOWER

882
00:31:50,141 --> 00:31:51,009
INTERCEPT, AND THE LITERATE

883
00:31:51,075 --> 00:31:52,610
FOLKS ARE STARTING AT A HIGHER

884
00:31:52,677 --> 00:31:54,979
INTERCEPT, BUT THERE'S LIKE NO

885
00:31:55,046 --> 00:31:56,414
SLOPE DIFFERENCE.

886
00:31:56,481 --> 00:31:58,383
AND SO WE ALWAYS HAVE TO KIND OF

887
00:31:58,449 --> 00:32:00,585
KEEP THIS DIAGNOSTIC THRESHOLD

888
00:32:00,652 --> 00:32:02,654
IN MIND, IT DOESN'T REALLY

889
00:32:02,720 --> 00:32:04,622
MATTER IN OUR HANDS WHETHER IT'S

890
00:32:04,689 --> 00:32:06,157
BASED ON JUST COGNITION OR

891
00:32:06,224 --> 00:32:08,993
WHETHER IT'S BASED ON COGNITION

892
00:32:09,060 --> 00:32:13,031
AND FUNCTION AND ADJUDICATED

893
00:32:13,097 --> 00:32:13,698
CONSENSUS CONFERENCE.

894
00:32:13,765 --> 00:32:17,201
WE DO HAVE THESE ISSUES OF

895
00:32:17,268 --> 00:32:18,303
DIAGNOSTIC THRESHOLD THAT MAKES

896
00:32:18,369 --> 00:32:22,240
IT SO THAT PEOPLE WHO START OFF

897
00:32:22,307 --> 00:32:23,741
LOWER HAVE A LOWER INTERCEPT,

898
00:32:23,808 --> 00:32:25,109
THEY MEET THAT THRESHOLD SOONER,

899
00:32:25,176 --> 00:32:29,781
AND THAT WILL AFFECT THE

900
00:32:29,847 --> 00:32:33,184
INCIDENCE RATES.

901
00:32:33,251 --> 00:32:34,686
MORE BEHIND THE SCENES DRAMA

902
00:32:34,752 --> 00:32:36,020
WITH DIAGNOSTIC CATEGORIES.

903
00:32:36,087 --> 00:32:37,655
WHILE ADULTS WITH MILD COGNITIVE

904
00:32:37,722 --> 00:32:39,490
IMPAIRMENT ARE CERTAINLY AT

905
00:32:39,557 --> 00:32:41,259
HIGHER RISK FOR DEVELOPING

906
00:32:41,326 --> 00:32:44,896
DEMENTIA, NOT ALL OF THEM THAT

907
00:32:44,962 --> 00:32:49,267
ARE DIAGNOSED WITH MCI ARE

908
00:32:49,334 --> 00:32:50,335
DIAGNOSED WITH DEMENTIA.

909
00:32:50,401 --> 00:32:52,770
THIS SHOWS ALMOST HALF THE

910
00:32:52,837 --> 00:32:54,072
INDIVIDUALS WITH INCIDENT MCI IN

911
00:32:54,138 --> 00:32:55,606
WHICAP WERE CLASSIFIED AS

912
00:32:55,673 --> 00:32:57,375
COGNITIVELY NORMAL AT FOLLOW-UP,

913
00:32:57,442 --> 00:32:59,877
WHICH WAS ABOUT 2 1/2 YEARS

914
00:32:59,944 --> 00:33:02,380
LATER.

915
00:33:02,447 --> 00:33:04,582
WE DID FIND ABOUT 13% PROGRESSED

916
00:33:04,649 --> 00:33:07,318
TO DEMENTIA AND 30% STAYED AT

917
00:33:07,385 --> 00:33:09,721
MCI, AND MULTIPLE DOMAIN MCI WAS

918
00:33:09,787 --> 00:33:11,022
LESS LIKELY TO REVERT BACK TO

919
00:33:11,089 --> 00:33:14,425
NORMAL, BUT THIS IS SORT OF THE

920
00:33:14,492 --> 00:33:16,060
MESSY INNER WORKINGS OF THE

921
00:33:16,127 --> 00:33:17,061
DIAGNOSES THAT WE HAVE WHEN

922
00:33:17,128 --> 00:33:17,829
WE'RE IN THE COMMUNITY, WHEN

923
00:33:17,895 --> 00:33:19,364
WE'RE IN THE COMMUNITY WE SEE A

924
00:33:19,430 --> 00:33:27,438
LOT OF FLUCTUATION.

925
00:33:27,505 --> 00:33:28,840
SO WE JUST REVIEWED THE

926
00:33:28,906 --> 00:33:29,841
CHALLENGE AT HAND, I DISCUSSED

927
00:33:29,907 --> 00:33:33,478
WHO TO STUDY IN MY HUMBLE

928
00:33:33,544 --> 00:33:35,113
OPINION, AND ALSO WHAT OUTCOMES

929
00:33:35,179 --> 00:33:38,082
WE MIGHT MEASURE AND WHAT WE

930
00:33:38,149 --> 00:33:40,051
NEED TO WATCH OUT FOR WITH THOSE

931
00:33:40,118 --> 00:33:41,486
OUTCOMES, AND NOW I'M GOING TO

932
00:33:41,552 --> 00:33:43,121
DIVE INTO POINT ON OUR LIFE

933
00:33:43,187 --> 00:33:45,022
COURSE MODEL, WORKING FROM THE

934
00:33:45,089 --> 00:33:47,625
RIGHT HAND OF THAT LIFE COURSE

935
00:33:47,692 --> 00:33:50,361
MODEL, WHICH IS DOWNSTREAM, ALL

936
00:33:50,428 --> 00:33:51,662
THE WAY LEFT, WHICH IS UPSTREAM

937
00:33:51,729 --> 00:33:53,731
IN THAT MODEL, TO IDENTIFY

938
00:33:53,798 --> 00:33:56,367
MEANINGFUL SOCIAL AND STRUCTURAL

939
00:33:56,434 --> 00:33:57,869
RISK AND RESILIENCE FACTORS FOR

940
00:33:57,935 --> 00:33:58,302
ALZHEIMER'S DISEASE.

941
00:33:58,369 --> 00:33:59,303
I'M GOING TO START WITH SOME

942
00:33:59,370 --> 00:34:01,506
COMPELLING EVIDENCE THAT

943
00:34:01,572 --> 00:34:02,473
ACCELERATED AGING CONTRIBUTES TO

944
00:34:02,540 --> 00:34:03,908
INEQUALITIES IN BRAIN AND

945
00:34:03,975 --> 00:34:06,210
COGNITION AMONG OLDER ADULTS.

946
00:34:06,277 --> 00:34:09,080
THIS FIRST STUDY USED A WHITE

947
00:34:09,147 --> 00:34:17,155
MATTER HYPERINTENSITY PROGRAM

948
00:34:17,221 --> 00:34:19,724
THAT ADAM BRICKMAN HAS PIONEERED

949
00:34:19,791 --> 00:34:23,728
IN THE WHICAP AND OFF SPRING

950
00:34:23,795 --> 00:34:30,501
STUDIES, AND AGE EFFECTS -- IN

951
00:34:30,568 --> 00:34:32,036
WHICAP AND OFFSPRING COHORTS.

952
00:34:32,103 --> 00:34:33,471
SO ALL THESE ANALYSES FOR THE

953
00:34:33,538 --> 00:34:35,239
PEOPLE WHO ARE RELATED, WHO DID

954
00:34:35,306 --> 00:34:36,541
MRI, WE ARE ADJUSTING FOR THAT,

955
00:34:36,607 --> 00:34:38,509
SO YOU DON'T HAVE TO WORRY ABOUT

956
00:34:38,576 --> 00:34:40,812
THAT IN THIS STUDY, BUT YOU CAN

957
00:34:40,878 --> 00:34:42,780
SEE IN THE WHITE AND LATINX

958
00:34:42,847 --> 00:34:43,748
PARTICIPANTS ON THE LEFT AND

959
00:34:43,815 --> 00:34:47,285
RIDE SIDES, THE RED, PINK AND

960
00:34:47,351 --> 00:34:49,654
BLUE, THERE'S AN INFLECTION

961
00:34:49,720 --> 00:34:54,692
POINT IN LATER AGE, BUT AMONG

962
00:34:54,759 --> 00:34:55,827
BLACK ADULTS IN THE MIDDLE, YOU

963
00:34:55,893 --> 00:34:58,529
SEE THAT THIS ACCELERATION IS

964
00:34:58,596 --> 00:35:00,865
ALREADY APPARENT IN MIDDLE AGE.

965
00:35:00,932 --> 00:35:04,235
SO IDIRA INTERPRETED THESE

966
00:35:04,302 --> 00:35:05,803
FINDINGS OF EVIDENCE OF

967
00:35:05,870 --> 00:35:08,072
SO-CALLED WEATHERING OR

968
00:35:08,139 --> 00:35:08,973
ACCELERATED BRAIN AGING WHICH IS

969
00:35:09,040 --> 00:35:10,374
A CUMULATIVE IMPACT OF

970
00:35:10,441 --> 00:35:11,476
STRUCTURAL RACISM AND SOCIAL

971
00:35:11,542 --> 00:35:12,443
PHYSICAL ECONOMIC ADVERSITIES

972
00:35:12,510 --> 00:35:15,313
THAT ARE FACED BY MINORITIZED

973
00:35:15,379 --> 00:35:16,848
PEOPLE, AND EMBODIED

974
00:35:16,914 --> 00:35:17,849
BIOLOGICALLY.

975
00:35:17,915 --> 00:35:19,584
SHE ALSO LOOKED AT CORTICAL

976
00:35:19,650 --> 00:35:20,651
THICKNESS, AND ESSENTIALLY FOUND

977
00:35:20,718 --> 00:35:21,652
THE SAME THING.

978
00:35:21,719 --> 00:35:24,322
THE LACK OF THAT INFLECTION

979
00:35:24,388 --> 00:35:28,559
POINT IN THE BLACK OFFSPRING AND

980
00:35:28,626 --> 00:35:30,728
WHICAP PARTICIPANTS.

981
00:35:30,795 --> 00:35:32,830
THIS IS JUSTINA'S PAPER WHERE

982
00:35:32,897 --> 00:35:35,099
SHE LOOKED AT DNA METHYLATION IN

983
00:35:35,166 --> 00:35:36,000
THE HEALTH AND RETIREMENT STUDY

984
00:35:36,067 --> 00:35:37,535
AND HOW THAT RELATED TO MEMORY

985
00:35:37,602 --> 00:35:40,805
LEVEL AND MEMORY SLOPE.

986
00:35:40,872 --> 00:35:41,138
OVER

987
00:35:41,205 --> 00:35:41,405
TIME.

988
00:35:41,472 --> 00:35:43,040
SHE FOUND THAT OVERALL

989
00:35:43,107 --> 00:35:44,575
ACCELERATED BIOLOGICAL AGING WAS

990
00:35:44,642 --> 00:35:47,111
ASSOCIATED WITH LOWER MEMORY

991
00:35:47,178 --> 00:35:47,912
PERFORMANCE IN THE HEALTH AND

992
00:35:47,979 --> 00:35:49,180
RETIREMENT STUDY, BUT THIS WAS

993
00:35:49,247 --> 00:35:51,516
ESPECIALLY THE CASE FOR WHITE

994
00:35:51,582 --> 00:35:53,217
MEN AND WHITE WOMEN.

995
00:35:53,284 --> 00:35:55,186
MANY OF THE RELATIONSHIPS

996
00:35:55,253 --> 00:35:57,188
BETWEEN BIOLOGICAL AGING

997
00:35:57,255 --> 00:35:58,556
INDICATORS, THESE BIOLOGICAL

998
00:35:58,623 --> 00:36:00,358
CLOCKS AND MEMORY PERFORMANCE,

999
00:36:00,424 --> 00:36:02,326
WERE THE STRONGEST FOR LATINX

1000
00:36:02,393 --> 00:36:03,728
WOMEN BUT THERE WEREN'T ENOUGH

1001
00:36:03,794 --> 00:36:07,999
OF THEM IN HRS, THIS BIOLOGICAL

1002
00:36:08,065 --> 00:36:09,567
COHORT, TO HAVE STATISTICAL

1003
00:36:09,634 --> 00:36:11,769
PRECISION.

1004
00:36:11,836 --> 00:36:13,070
BLACK WOMEN CONSISTENTLY

1005
00:36:13,137 --> 00:36:14,739
DEMONSTRATED THE WEAKEST

1006
00:36:14,805 --> 00:36:16,040
ASSOCIATIONS BETWEEN DNA

1007
00:36:16,107 --> 00:36:17,241
METHYLATION AND MEMORY

1008
00:36:17,308 --> 00:36:21,512
TRAJECTORIES.

1009
00:36:21,579 --> 00:36:24,148
WE'VE JUST NOW TALKED ABOUT

1010
00:36:24,215 --> 00:36:25,116
BIOLOGICAL AGING.

1011
00:36:25,182 --> 00:36:26,317
NOW WE'RE GOING TO MOVE LEFT

1012
00:36:26,384 --> 00:36:27,618
AGAIN ON OUR LIFE COURSE MODEL

1013
00:36:27,685 --> 00:36:31,389
AND TALK ABOUT SCHOOLING, ABOUT

1014
00:36:31,455 --> 00:36:33,858
WHAT WE KNOW ABOUT -- WELL, WE

1015
00:36:33,925 --> 00:36:36,494
DO KNOW THAT EDUCATIONAL

1016
00:36:36,561 --> 00:36:38,262
ATTAINMENT IS CONSISTENTLY

1017
00:36:38,329 --> 00:36:39,730
ASSOCIATED WITH LOWER RISK OF

1018
00:36:39,797 --> 00:36:40,131
ADRD.

1019
00:36:40,197 --> 00:36:42,567
IS IT CAUSAL, IS IT LIMITED TO

1020
00:36:42,633 --> 00:36:44,969
ATTAINMENT, ARE THERE SIMILAR

1021
00:36:45,036 --> 00:36:47,038
RETURNS ACROSS GROUPS?

1022
00:36:47,104 --> 00:36:50,274
THIS IS A PICTURE OF A SCHOOL IN

1023
00:36:50,341 --> 00:36:52,176
THE DOMINICAN REPUBLIC IN THE

1024
00:36:52,243 --> 00:36:54,912
1940s ON THE LEFT, AND A

1025
00:36:54,979 --> 00:36:56,447
ONE-ROOM ALL-BLACK SCHOOL ROOM

1026
00:36:56,514 --> 00:37:00,484
IN ALABAMA IN THE 1930s.

1027
00:37:00,551 --> 00:37:01,719
AND MANY OF OUR PARTICIPANTS

1028
00:37:01,786 --> 00:37:03,254
WENT TO SCHOOL IN THOSE PLACES

1029
00:37:03,321 --> 00:37:06,657
IN THE WHICAP STUDY IN NORTHERN

1030
00:37:06,724 --> 00:37:09,293
MANHATTAN.

1031
00:37:09,360 --> 00:37:10,895
BECAUSE WE HAD RECRUITED PEOPLE

1032
00:37:10,962 --> 00:37:12,229
OVER THREE WAVES IN WHICAP, IT

1033
00:37:12,296 --> 00:37:16,734
MADE IT POSSIBLE TO STUDY COHORT

1034
00:37:16,801 --> 00:37:20,004
OR PERIOD EFFECTS IN ADRD, AND

1035
00:37:20,071 --> 00:37:21,238
IN 2019, WE HAD FOLLOWED PEOPLE

1036
00:37:21,305 --> 00:37:22,440
LONG ENOUGH THAT WE COULD MATCH

1037
00:37:22,506 --> 00:37:23,941
BIRTH COHORTS ON AGE IN THE

1038
00:37:24,008 --> 00:37:26,243
STUDY, SO ALL THESE PEOPLE IN

1039
00:37:26,310 --> 00:37:28,779
THIS FIGURE HERE ARE THE SAME

1040
00:37:28,846 --> 00:37:30,114
AGE WHEN WE'RE GETTING DATA FROM

1041
00:37:30,181 --> 00:37:33,184
THEM.

1042
00:37:33,250 --> 00:37:34,385
BUT THEY ARE FROM DIFFERENT

1043
00:37:34,452 --> 00:37:38,623
BIRTH COHORTS.

1044
00:37:38,689 --> 00:37:44,028
AND WHAT WAS FOUND WAS A BENEFIT

1045
00:37:44,095 --> 00:37:46,197
OF BEING BORN LATER, BOTH WITH

1046
00:37:46,263 --> 00:37:51,369
RESPECT TO I TO INCIDENT ALZHEIS

1047
00:37:51,435 --> 00:37:53,304
DISEASE, BUT PEOPLE BORN LATER

1048
00:37:53,371 --> 00:37:55,706
HAD A SLOWER MEMORY TEE KLEIN

1049
00:37:55,773 --> 00:38:04,815
OVER TIME.

1050
00:38:04,882 --> 00:38:07,018
WHAT WAS FOUND WAS THE BENEFIT

1051
00:38:07,084 --> 00:38:09,453
OF BEING BORN LATER WAS

1052
00:38:09,520 --> 00:38:11,188
EXPLAINED BY HIGHER CHILDHOOD OR

1053
00:38:11,255 --> 00:38:12,156
FAMILY SES AND HIGHER

1054
00:38:12,223 --> 00:38:12,923
EDUCATIONAL ATTAINMENT.

1055
00:38:12,990 --> 00:38:15,893
I MEAN, THESE SLOPES WERE

1056
00:38:15,960 --> 00:38:17,662
OVERLAPPING.

1057
00:38:17,728 --> 00:38:18,696
AFTER ACCOUNTING FOR THOSE TWO

1058
00:38:18,763 --> 00:38:19,530
FACTORS.

1059
00:38:19,597 --> 00:38:21,298
BECAUSE THOSE SECULAR TRENDS IN

1060
00:38:21,365 --> 00:38:22,299
EDUCATIONAL ATTAINMENT WERE DUE

1061
00:38:22,366 --> 00:38:25,202
TO POLICY CHANGES, REQUIRING

1062
00:38:25,269 --> 00:38:27,071
ADDITIONAL YEARS OF SCHOOL, I

1063
00:38:27,138 --> 00:38:30,041
THINK THIS ADDS TO THE LIST OF

1064
00:38:30,107 --> 00:38:31,575
EVIDENCE THAT THERE'S A CAUSAL

1065
00:38:31,642 --> 00:38:33,778
LINK BETWEEN EDUCATIONAL

1066
00:38:33,844 --> 00:38:34,311
ATTAINMENT AND ALZHEIMER'S

1067
00:38:34,378 --> 00:38:39,684
DISEASE.

1068
00:38:39,750 --> 00:38:42,186
POLICY CHANGES ACROSS THE NATION

1069
00:38:42,253 --> 00:38:43,621
ARE NATURAL EXPERIMENTS, OR THEY

1070
00:38:43,688 --> 00:38:46,691
CAN BE OFFERED NATURAL

1071
00:38:46,757 --> 00:38:47,792
EXPERIMENTS TO ESTABLISH THESE

1072
00:38:47,858 --> 00:38:52,296
CAUSAL LINKS.

1073
00:38:52,363 --> 00:38:53,597
AND WE LOOKED UP INFORMATION

1074
00:38:53,664 --> 00:38:54,932
ABOUT LENGTH OF SCHOOL YEAR,

1075
00:38:54,999 --> 00:38:56,000
STUDENT-TEACHER RATIO AND

1076
00:38:56,067 --> 00:38:58,202
PERCENT ATTENDANCE IN

1077
00:38:58,269 --> 00:38:59,670
ADMINISTRATIVE RECORDS FROM 1911

1078
00:38:59,737 --> 00:39:03,274
ALL THE WAY TO 1960.

1079
00:39:03,340 --> 00:39:06,877
AND IN THE REGARDS COHORT, WHERE

1080
00:39:06,944 --> 00:39:09,180
BLACK PEOPLE AND PEOPLE IN THE

1081
00:39:09,246 --> 00:39:10,748
STROKE BELT ARE OVERSAMPLED, WE

1082
00:39:10,815 --> 00:39:12,249
WERE ABLE TO INCLUDE ALMOST

1083
00:39:12,316 --> 00:39:13,584
20,000 PEOPLE AND FOUND THAT

1084
00:39:13,651 --> 00:39:16,754
HIGHER INVESTMENT WITHIN THESE

1085
00:39:16,821 --> 00:39:18,389
ADMINISTRATIVE RECORDS IN

1086
00:39:18,456 --> 00:39:19,056
ELEMENTARY SCHOOLS WERE

1087
00:39:19,123 --> 00:39:20,458
ASSOCIATED WITH LOWER RISK OF

1088
00:39:20,524 --> 00:39:22,960
COGNITIVE IMPAIRMENT LATER IN

1089
00:39:23,027 --> 00:39:24,195
LIFE.

1090
00:39:24,261 --> 00:39:25,629
THAT EFFECT WAS STRONGEST IN

1091
00:39:25,696 --> 00:39:27,398
WHITE PEOPLE, ESPECIALLY WHITE

1092
00:39:27,465 --> 00:39:29,133
WOMEN, BUT WEAKEST IN BLACK

1093
00:39:29,200 --> 00:39:36,607
PEOPLE, ESPECIALLY BLACK MEN.

1094
00:39:36,674 --> 00:39:38,008
I'M GOING TO TURN TO PROJECT

1095
00:39:38,075 --> 00:39:39,877
TALENT, WHICH IS ONE EXAMPLE OF

1096
00:39:39,944 --> 00:39:41,078
THESE EDUCATIONAL COHORT THAT

1097
00:39:41,145 --> 00:39:43,848
ARE NOW BEING LEVERAGED THANKS

1098
00:39:43,914 --> 00:39:47,885
TO NIA FUNDING TO STUDY LATER

1099
00:39:47,952 --> 00:39:57,728
LIFE COGNITION, AND SO PROJECT

1100
00:39:57,795 --> 00:40:02,666
TALENT STARTED IN 1960 WITH

1101
00:40:02,733 --> 00:40:04,201
377,000 9TH THROUGH 12TH GRADERS

1102
00:40:04,268 --> 00:40:07,138
WHO WERE FROM 1,200 SCHOOLS

1103
00:40:07,204 --> 00:40:10,741
AROUND THE COUNTRY THAT WERE

1104
00:40:10,808 --> 00:40:15,246
RANDOMLY SAMPLED.

1105
00:40:15,312 --> 00:40:16,580
AND EVERY STUDENT IN EACH SCHOOL

1106
00:40:16,647 --> 00:40:17,915
THAT WAS SELECTED WAS A

1107
00:40:17,982 --> 00:40:20,217
PARTICIPANT IN TWO DAYS OF

1108
00:40:20,284 --> 00:40:20,751
TESTING.

1109
00:40:20,818 --> 00:40:22,720
AND THAT INCLUDED PERSONALITY,

1110
00:40:22,787 --> 00:40:24,488
KNOWLEDGE AND COGNITIVE ABILITY

1111
00:40:24,555 --> 00:40:25,990
DATA, AND DEMOGRAPHIC QUESTIONS,

1112
00:40:26,056 --> 00:40:27,558
AND THEN THE PROJECT TALENT

1113
00:40:27,625 --> 00:40:30,761
AGING STUDY 58 YEARS LATER

1114
00:40:30,828 --> 00:40:31,495
TRACKED 22,000 PEOPLE WHO WERE A

1115
00:40:31,562 --> 00:40:35,132
PART OF THAT INITIAL STUDY IN

1116
00:40:35,199 --> 00:40:36,634
1960, AND SO THIS IS A

1117
00:40:36,700 --> 00:40:37,968
SCHOOL-BASED COHORT.

1118
00:40:38,035 --> 00:40:41,906
AND WHAT NIKA FOUND AND WAS ABLE

1119
00:40:41,972 --> 00:40:44,975
TO PUBLISH LAST YEAR, SHE FIRST

1120
00:40:45,042 --> 00:40:47,178
DEVELOPED INDICATORS OF HIGH

1121
00:40:47,244 --> 00:40:48,245
SCHOOL QUALITY THAT WERE

1122
00:40:48,312 --> 00:40:49,180
REPORTED BY PRINCIPALS AT THE

1123
00:40:49,246 --> 00:40:53,851
TIME OF SCHOOLING, AND PREDICTED

1124
00:40:53,918 --> 00:40:55,553
COGNITIVE FUNCTION, WHICH WAS

1125
00:40:55,619 --> 00:40:56,921
DONE OVER THE PHONE, 58 YEARS

1126
00:40:56,987 --> 00:40:58,622
LATER.

1127
00:40:58,689 --> 00:41:01,392
SO THOSE SCHOOL QUALITY

1128
00:41:01,458 --> 00:41:03,160
INDICATORS WERE TEACHER SALARY,

1129
00:41:03,227 --> 00:41:05,329
SCHOOL SIZE, NUMBER OF TEACHERS

1130
00:41:05,396 --> 00:41:06,297
WITH GRADUATE TRAINING AS AN

1131
00:41:06,363 --> 00:41:07,198
EXAMPLE.

1132
00:41:07,264 --> 00:41:09,366
WHAT NIKA FOUND WAS THAT

1133
00:41:09,433 --> 00:41:10,367
ATTENDING SCHOOLS WITH A HIGHER

1134
00:41:10,434 --> 00:41:11,802
NUMBER OF TEACHERS WITH GRADUATE

1135
00:41:11,869 --> 00:41:14,205
TRAINING WAS THE CLEAREST

1136
00:41:14,271 --> 00:41:16,740
PREDICTOR OF LATER LIFE

1137
00:41:16,807 --> 00:41:19,143
COGNITION, AND SCHOOL QUALITY

1138
00:41:19,210 --> 00:41:21,245
ESPECIALLY MATTERED FOR LANGUAGE

1139
00:41:21,312 --> 00:41:23,848
ABILITIES, AS THEY WERE MEASURED

1140
00:41:23,914 --> 00:41:25,282
BY PROJECT TALENT AGING STUDY.

1141
00:41:25,349 --> 00:41:26,817
SHE ALSO FOUND THAT TEACHER

1142
00:41:26,884 --> 00:41:28,886
SALARY AND SCHOOL SIZE HAD A

1143
00:41:28,953 --> 00:41:31,856
LARGER IMPACT AMONG WOMEN IN

1144
00:41:31,922 --> 00:41:32,857
PROJECT TALENT AS OPPOSED TO

1145
00:41:32,923 --> 00:41:35,693
MEN.

1146
00:41:35,759 --> 00:41:36,794
BLACK RESPONDENTS WERE DISPRO

1147
00:41:36,861 --> 00:41:39,430
FDISPROPORTIONATELY EXPOSED TO

1148
00:41:39,496 --> 00:41:41,065
LOW QUALITY HIGH SCHOOLS, I

1149
00:41:41,131 --> 00:41:42,499
DON'T THINK THAT'S NEW

1150
00:41:42,566 --> 00:41:45,970
KNOWLEDGE, BUT THERE WERE NO

1151
00:41:46,036 --> 00:41:48,005
INTERACTIONS.

1152
00:41:48,072 --> 00:41:49,540
SO IN OTHER WORDS, THE MAIN

1153
00:41:49,607 --> 00:41:50,407
EFFECT OF THE SCHOOL QUALITY

1154
00:41:50,474 --> 00:41:51,508
FACTORS WAS THE SAME ACROSS

1155
00:41:51,575 --> 00:41:52,810
RACIAL AND ETHNIC GROUPS.

1156
00:41:52,877 --> 00:41:54,011
BUT WHAT THIS MEANS BECAUSE

1157
00:41:54,078 --> 00:41:57,214
THERE'S A HIGHER SORT OF

1158
00:41:57,281 --> 00:41:58,082
PREVALENCE OF PEOPLE IN THE

1159
00:41:58,148 --> 00:41:59,516
BLACK POPULATION WHO ARE BEING

1160
00:41:59,583 --> 00:42:03,120
EXPOSED TO THESE LOWER SCHOOL

1161
00:42:03,187 --> 00:42:07,591
QUALITY CONDITIONS, THAT

1162
00:42:07,658 --> 00:42:08,792
INCREASED INVESTMENT IN SCHOOLS,

1163
00:42:08,859 --> 00:42:09,793
ESPECIALLY THOSE THAT SERVE

1164
00:42:09,860 --> 00:42:11,562
BLACK CHILDREN, COULD BE A VERY

1165
00:42:11,629 --> 00:42:14,498
POWERFUL STRATEGY TO IMPROVE

1166
00:42:14,565 --> 00:42:16,033
LATER LIFE COGNITIVE HEALTH

1167
00:42:16,100 --> 00:42:21,939
AMONG OLDER ADULTS IN THE U.S.

1168
00:42:22,006 --> 00:42:23,040
FINALLY TO END UP THE TALK I'M

1169
00:42:23,107 --> 00:42:33,651
GOING TO TALK ABOUT SYSTEMIC --

1170
00:42:34,351 --> 00:42:37,855
THIS IS THE MEAN AGE 55 PEOPLE

1171
00:42:37,922 --> 00:42:40,457
WHERE WE GAVE A MEASURE, A

1172
00:42:40,524 --> 00:42:43,127
CLASSIC MEASURE OF EXPOSURE TO

1173
00:42:43,193 --> 00:42:44,428
DISCRIMINATION, INCLUDING DAILY

1174
00:42:44,495 --> 00:42:47,164
DISCRIMINATION.

1175
00:42:47,231 --> 00:42:49,566
AND BASICALLY WHAT THIS CHART

1176
00:42:49,633 --> 00:42:52,303
SHOWS IS THAT AMONG NON-HISPANIC

1177
00:42:52,369 --> 00:42:53,570
BLACK PARTICIPANTS IN THE

1178
00:42:53,637 --> 00:42:54,838
OFFSPRING STUDY WHO ARE IN

1179
00:42:54,905 --> 00:42:55,739
ORANGE HERE, THEY HAD THE

1180
00:42:55,806 --> 00:42:59,576
HIGHEST MEAN EXPOSURE TO DAILY

1181
00:42:59,643 --> 00:43:06,150
RACISM COMPARED TO LATINX, BLACK

1182
00:43:06,216 --> 00:43:08,152
AND WHITE IN GREY.

1183
00:43:08,218 --> 00:43:09,486
BLACK PEOPLE EXPERIENCED

1184
00:43:09,553 --> 00:43:10,554
INTERPERSONAL DISCRIMINATION AT

1185
00:43:10,621 --> 00:43:12,356
LEAST ONCE EVERY WEEK.

1186
00:43:12,423 --> 00:43:15,759
WE ALSO LOOKED AT REPORTS OF

1187
00:43:15,826 --> 00:43:17,494
OCCURRENCE AND FREQUENCY ON THE

1188
00:43:17,561 --> 00:43:20,564
MAJOR DISCRIMINATION SCALE TO

1189
00:43:20,631 --> 00:43:21,565
MEASURE INSTITUTIONAL RACISM,

1190
00:43:21,632 --> 00:43:23,200
AND THE SECOND BAR CHART THAT I

1191
00:43:23,267 --> 00:43:26,804
JUST PULLED UP SHOWS THAT

1192
00:43:26,870 --> 00:43:27,905
NON-HISPANIC BLACK PEOPLE

1193
00:43:27,972 --> 00:43:29,006
EXPERIENCED ALMOST SIX CIVIL

1194
00:43:29,073 --> 00:43:30,341
RIGHTS VIOLATIONS ON AVERAGE IN

1195
00:43:30,407 --> 00:43:33,744
THEIR LIFETIME.

1196
00:43:33,811 --> 00:43:35,612
WE ALSO KNEW THAT RACISM IS

1197
00:43:35,679 --> 00:43:38,248
MAINTAINED BY POLICIES AND OTHER

1198
00:43:38,315 --> 00:43:39,783
STRUCTURAL FACTORS, AND SO TO

1199
00:43:39,850 --> 00:43:42,286
REPRESENT THIS, WE ACTUALLY HAD

1200
00:43:42,353 --> 00:43:45,022
THE PARENTS RESIDENTIAL

1201
00:43:45,089 --> 00:43:45,823
SEGREGATION, WHICH REPRESENTS

1202
00:43:45,889 --> 00:43:47,458
THE CONDITIONS UNDER WHICH THESE

1203
00:43:47,524 --> 00:43:49,860
OFFSPRING LIVED AS CHILDREN

1204
00:43:49,927 --> 00:43:54,465
DURING CHILDHOOD, AND WE DID

1205
00:43:54,531 --> 00:43:56,667
THAT TO STUDY INSTITUTIONAL

1206
00:43:56,734 --> 00:43:59,370
DISINVESTMENT THAT REINFORCE

1207
00:43:59,436 --> 00:43:59,870
RACIAL INEQUALITIES.

1208
00:43:59,937 --> 00:44:02,373
AT LEAST HALF OF THE BLACK AND

1209
00:44:02,439 --> 00:44:03,741
LATINX PARTICIPANTS LIVED IN

1210
00:44:03,807 --> 00:44:04,508
SEGREGATED NEIGHBORHOODS DURING

1211
00:44:04,575 --> 00:44:05,709
CHILDHOOD, AND IN CONTRAST, THAT

1212
00:44:05,776 --> 00:44:08,012
WAS TRUE OF ONLY ABOUT 8% OF THE

1213
00:44:08,078 --> 00:44:17,087
NON-HISPANIC WHITE PARTICIPANTS.

1214
00:44:17,154 --> 00:44:19,156
SO WE USE LINEAR REGRESSION AND

1215
00:44:19,223 --> 00:44:20,824
ADJUSTED FOR AGE AND EDUCATION,

1216
00:44:20,891 --> 00:44:22,059
SCHOOLING, YEARS OF SCHOOLING,

1217
00:44:22,126 --> 00:44:23,594
TO EXAMINE THE RELATIONSHIPS

1218
00:44:23,660 --> 00:44:26,196
BETWEEN INTERPERSONAL RACISM AND

1219
00:44:26,263 --> 00:44:27,231
MEMORY.

1220
00:44:27,297 --> 00:44:28,565
THIS PLOT SHOWS BETA ESTIMATES

1221
00:44:28,632 --> 00:44:30,300
AND CONFIDENCE INTERVALS FOR

1222
00:44:30,367 --> 00:44:31,835
THIS RELATIONSHIP IN THE OVERALL

1223
00:44:31,902 --> 00:44:32,736
SAMPLE AND ALSO FOR EACH OF THE

1224
00:44:32,803 --> 00:44:35,672
RACIAL AND ETHNIC GROUPS.

1225
00:44:35,739 --> 00:44:37,107
AND THEN THE YELLOW DOT AT THE

1226
00:44:37,174 --> 00:44:38,876
END IS SHOWING THE RELATIONSHIP

1227
00:44:38,942 --> 00:44:40,944
OF AGE TO MEMORY FOR COMPARISON

1228
00:44:41,011 --> 00:44:44,014
FOR YOU.

1229
00:44:44,081 --> 00:44:45,916
WE FOUND RELIABLE RELATIONSHIPS

1230
00:44:45,983 --> 00:44:46,784
BETWEEN DAILY EXPERIENCES OF

1231
00:44:46,850 --> 00:44:49,553
RACISM AND MEMORY IN THE WHOLE

1232
00:44:49,620 --> 00:44:51,255
SAMPLE, AND THIS CORRESPONDS TO

1233
00:44:51,321 --> 00:44:52,289
ABOUT THREE YEARS OF

1234
00:44:52,356 --> 00:44:53,290
CHRONOLOGICAL AGE AND WAS DRIVEN

1235
00:44:53,357 --> 00:44:54,725
BY THE NON-HISPANIC BLACK

1236
00:44:54,792 --> 00:44:55,059
PARTICIPANTS.

1237
00:44:55,125 --> 00:44:58,328
I WANT TO MENTION THAT ACTUALLY

1238
00:44:58,395 --> 00:45:00,297
MICHELLE MIELKE BROUGHT IT TO MY

1239
00:45:00,364 --> 00:45:01,965
ATTENTION BECAUSE I DON'T READ

1240
00:45:02,032 --> 00:45:02,933
EVERY JOURNAL ARTICLE BUT SHE

1241
00:45:03,000 --> 00:45:06,770
DID A REALLY COOL STUDY IN THE

1242
00:45:06,837 --> 00:45:08,072
ALZHEIMER'S ASSOCIATION JOURNAL

1243
00:45:08,138 --> 00:45:10,741
RECENTLY, WHERE SHE LOOKED AT A

1244
00:45:10,808 --> 00:45:11,875
BLACK COHORT THAT'S BEEN

1245
00:45:11,942 --> 00:45:14,912
FOLLOWED FOR MANY, MANY YEARS

1246
00:45:14,978 --> 00:45:16,447
AND USED MANY DIFFERENT BLOOD

1247
00:45:16,513 --> 00:45:18,549
DRAWS IN LOOKING AT PLASMA

1248
00:45:18,615 --> 00:45:20,651
AMYLOID LEVELS, AND SHE FOUND A

1249
00:45:20,717 --> 00:45:23,153
RELATIONSHIP IN THAT BLACK

1250
00:45:23,220 --> 00:45:27,224
COHORT BETWEEN ER EVERY DAY

1251
00:45:27,291 --> 00:45:28,992
DISCRIMINATION AND LEVELS OF

1252
00:45:29,059 --> 00:45:30,294
PLASMA AMYLOID IN THAT SAMPLE.

1253
00:45:30,360 --> 00:45:31,862
SO CHECK THAT ONE OUT, I'M STILL

1254
00:45:31,929 --> 00:45:32,729
PROCESSING IT MYSELF.

1255
00:45:32,796 --> 00:45:35,566
AND HOPE TO TAKE A LOOK AT IT

1256
00:45:35,632 --> 00:45:37,334
AND SEE IF IT IS REPLICATED.

1257
00:45:37,401 --> 00:45:39,970
THIS PLOT HAS THE SAME IN OUR

1258
00:45:40,037 --> 00:45:40,637
COHORT.

1259
00:45:40,704 --> 00:45:41,939
THIS PLOT HAS THE SAME LAYOUT.

1260
00:45:42,005 --> 00:45:43,307
THIS TIME WE'RE SHOWING THE

1261
00:45:43,373 --> 00:45:44,808
RELATIONSHIP OF INSTITUTIONAL

1262
00:45:44,875 --> 00:45:46,043
RACISM WITH DELAYED MEMORY.

1263
00:45:46,110 --> 00:45:47,678
THERE WAS A RELIABLE

1264
00:45:47,744 --> 00:45:49,580
RELATIONSHIP BETWEEN

1265
00:45:49,646 --> 00:45:51,215
INSTITUTIONAL RACISM AND MEMORY

1266
00:45:51,281 --> 00:45:53,050
SCORES AMONG NON-HISPANIC BLACK

1267
00:45:53,117 --> 00:45:54,351
PARTICIPANTS SO THAT EACH

1268
00:45:54,418 --> 00:45:55,385
REPORTED CIVIL RIGHTS VIOLATION

1269
00:45:55,452 --> 00:45:57,354
CORRESPONDED TO THE EFFECT OF

1270
00:45:57,421 --> 00:45:58,889
ABOUT 4 1/2 YEARS OF AGE ON

1271
00:45:58,956 --> 00:46:00,958
MEMORY.

1272
00:46:01,024 --> 00:46:01,992
AND THEN FINALLY, PARTICIPANTS

1273
00:46:02,059 --> 00:46:04,061
WHO LIVED IN MORE RACIALLY AND

1274
00:46:04,128 --> 00:46:05,262
ETHNICALLY SEG TATE GATED

1275
00:46:05,329 --> 00:46:08,465
NEIGHBORHOODS WHEN THEY GREW UP

1276
00:46:08,532 --> 00:46:09,666
HAD MORE DELAYED MEMORY SCORES

1277
00:46:09,733 --> 00:46:11,635
BUT THIS WAS NOT RELIABLE

1278
00:46:11,702 --> 00:46:13,504
STATISTICALLY IN MOST OF THE

1279
00:46:13,570 --> 00:46:14,638
SAMPLE EXCEPT FOR THE ENTIRE

1280
00:46:14,705 --> 00:46:14,905
SAMPLE.

1281
00:46:14,972 --> 00:46:16,874
YOU CAN SEE HOW SEGREGATED OUR

1282
00:46:16,940 --> 00:46:19,610
SAMPLE IS BY THAT.

1283
00:46:19,676 --> 00:46:23,247
SO IN SUM, I HAVE GONE OVER THE

1284
00:46:23,313 --> 00:46:24,448
CONSIDERATIONS FOR WHO TO STUDY,

1285
00:46:24,515 --> 00:46:26,483
WHAT TO MEASURE, AND THE WAYS

1286
00:46:26,550 --> 00:46:27,985
THAT WE HAVE TRIED TO TACKLE

1287
00:46:28,051 --> 00:46:30,287
SOME OF THESE STRUCTURAL AND

1288
00:46:30,354 --> 00:46:31,922
SOCIAL FACTORS.

1289
00:46:31,989 --> 00:46:33,457
I THINK THAT SOME CHALLENGES

1290
00:46:33,524 --> 00:46:36,994
THAT WE AND THE FIELD ARE FACING

1291
00:46:37,060 --> 00:46:38,395
ARE ABOUT THE COMMITMENT TO

1292
00:46:38,462 --> 00:46:40,397
COMMUNITY ENGAGEMENT, HOW MUCH

1293
00:46:40,464 --> 00:46:42,266
IT TAKES, HOW LONG IT TAKES, HOW

1294
00:46:42,332 --> 00:46:45,769
MUCH MONEY IT COSTS.

1295
00:46:45,836 --> 00:46:48,272
I AM CONFLICTED OF OUR FINDING

1296
00:46:48,338 --> 00:46:49,740
OF RETURNS TO SCHOOLING,

1297
00:46:49,806 --> 00:46:50,674
DIFFERENTIAL RETURNS TO

1298
00:46:50,741 --> 00:46:51,675
SCHOOLING ACROSS RACIALIZED

1299
00:46:51,742 --> 00:46:53,110
GROUPS BECAUSE I THINK THIS HAS

1300
00:46:53,177 --> 00:46:54,077
IMPLICATIONS FOR INTERVENTIONS,

1301
00:46:54,144 --> 00:46:55,445
WHICH COULD WIDEN DISPARITIES IF

1302
00:46:55,512 --> 00:46:58,849
THEY ARE NOT TARGETED CORRECTLY.

1303
00:46:58,916 --> 00:47:00,817
WE ARE WORRIED ABOUT THE SPATIAL

1304
00:47:00,884 --> 00:47:02,386
SCALE FOR AREA LEVEL EXPOSURES

1305
00:47:02,452 --> 00:47:03,587
AND, THEREFORE, SORT OF THE

1306
00:47:03,654 --> 00:47:06,123
SPATIAL SCALE IN WHICH

1307
00:47:06,190 --> 00:47:08,992
INTERVENTIONS MIGHT IMPACT

1308
00:47:09,059 --> 00:47:11,395
COGNITION AND COGNITIVE AGING.

1309
00:47:11,461 --> 00:47:13,030
WE NEED TO WORK ON INCORPORATING

1310
00:47:13,096 --> 00:47:14,331
MORE RESILIENT STRATEGIES INTO

1311
00:47:14,398 --> 00:47:16,567
OUR WORK AND NOT RELYING ON

1312
00:47:16,633 --> 00:47:20,270
DEFICIT MODELS.

1313
00:47:20,337 --> 00:47:21,838
MIDDLE AGE, MID LIFE COHORTS

1314
00:47:21,905 --> 00:47:23,674
NEED TO HAPPEN BECAUSE

1315
00:47:23,740 --> 00:47:25,475
DISPARITIES NARROW WITH AGE.

1316
00:47:25,542 --> 00:47:26,810
WE STILL HAVE SOME CHALLENGES

1317
00:47:26,877 --> 00:47:28,212
FOR COGNITIVE MEASURE

1318
00:47:28,278 --> 00:47:29,413
DEVELOPMENT, I THINK, IN

1319
00:47:29,479 --> 00:47:32,282
MULTIPLE DOMAINS.

1320
00:47:32,349 --> 00:47:34,685
AND I THINK THERE'S A CONFLICT

1321
00:47:34,751 --> 00:47:38,388
BETWEEN THE COST OF OVERSAMPLING

1322
00:47:38,455 --> 00:47:40,390
WHEN YOU DO A STUDY AND THIS

1323
00:47:40,457 --> 00:47:41,925
CHALLENGE OF INTERSECTIONALITY,

1324
00:47:41,992 --> 00:47:43,594
WHERE YOU KNOW, NOT ONLY DO YOU

1325
00:47:43,660 --> 00:47:45,095
NEED TO HAVE ENOUGH PEOPLE TO

1326
00:47:45,162 --> 00:47:46,363
LOOK AT RACIAL AND ETHNIC

1327
00:47:46,430 --> 00:47:48,632
GROUPS, BUT YOU REALLY NEED TO

1328
00:47:48,699 --> 00:47:50,400
CHARACTERIZE BLACK MEN AND BLACK

1329
00:47:50,467 --> 00:47:52,736
WOMEN AS SEPARATE GROUPS, LATINX

1330
00:47:52,803 --> 00:47:55,906
WOMEN AND LATINX MEN, AND SO ON,

1331
00:47:55,973 --> 00:47:57,341
AS SEPARATE GROUPS.

1332
00:47:57,407 --> 00:48:00,210
SO IN I THINK WHAT I'VE TALKED

1333
00:48:00,277 --> 00:48:02,746
ABOUT IS STRUCTURAL POLICIES

1334
00:48:02,813 --> 00:48:04,147
THAT NARROW BRAIN HEALTH

1335
00:48:04,214 --> 00:48:06,116
DISPARITIES FOR US TO AVOID THIS

1336
00:48:06,183 --> 00:48:07,718
IDEA OF HEALTHISM, WHICH WAS

1337
00:48:07,784 --> 00:48:09,553
REALLY SORT OF COINED BY THIS

1338
00:48:09,620 --> 00:48:11,188
GUY NAMED CRAWFORD AND THEN

1339
00:48:11,255 --> 00:48:16,059
RECENTLY BROUGHT UP IN A NICE

1340
00:48:16,126 --> 00:48:18,362
COMMENTARY BY TIM DALY WHICH IS

1341
00:48:18,428 --> 00:48:19,663
ESSENTIALLY BLAMING PEOPLE,

1342
00:48:19,730 --> 00:48:20,831
HEALTHISM IS BLAMING PEOPLE AND

1343
00:48:20,897 --> 00:48:24,968
PUTTING THE ONUS ON THEM FOR

1344
00:48:25,035 --> 00:48:26,603
IMPROVING THEIR SITUATION IN

1345
00:48:26,670 --> 00:48:27,137
LIFE.

1346
00:48:27,204 --> 00:48:28,839
INSTEAD, IF WE CAN FOCUS ON

1347
00:48:28,905 --> 00:48:31,441
STRUCTURAL POLICIES, INVESTMENT

1348
00:48:31,508 --> 00:48:33,410
IN TEACHERS AND SCHOOLS THAT

1349
00:48:33,477 --> 00:48:35,979
SERVE MINORITIZED CHILDREN,

1350
00:48:36,046 --> 00:48:38,382
HOUSING INVESTMENTS, REDUCING

1351
00:48:38,448 --> 00:48:39,683
NEIGHBORHOOD INEQUALITIES, I

1352
00:48:39,750 --> 00:48:41,985
KNOW THAT'S NOT EASY TO DO, BUT

1353
00:48:42,052 --> 00:48:43,020
I'VE LISTED SOME OF THOSE

1354
00:48:43,086 --> 00:48:44,888
FACTORS THERE.

1355
00:48:44,955 --> 00:48:47,090
WE HAVE -- THERE IS SOME NEW

1356
00:48:47,157 --> 00:48:49,359
EVIDENCE FROM SOUTH AFRICA THAT

1357
00:48:49,426 --> 00:48:51,962
CASH TRANSFERS BENEFIT LATER

1358
00:48:52,029 --> 00:48:52,929
LIFE HEALTH AND THAT WILL BE

1359
00:48:52,996 --> 00:48:54,698
COMING OUT SOON AND I'M VERY

1360
00:48:54,765 --> 00:48:58,535
INTERESTED IN THIS IDEA OF BABY

1361
00:48:58,602 --> 00:49:02,806
BONDS AS -- AND CASH AS A WAY OF

1362
00:49:02,873 --> 00:49:06,877
IMPROVING INCOME AND SECURITY,

1363
00:49:06,943 --> 00:49:10,781
REDUCING PRECARITY, UNIVERSAL

1364
00:49:10,847 --> 00:49:11,181
INCOME.

1365
00:49:11,248 --> 00:49:14,017
WE HAVE A STUDY FROM PEOPLE AT

1366
00:49:14,084 --> 00:49:15,252
BERKELEY SHOWING FOOD STAMPS AS

1367
00:49:15,319 --> 00:49:17,688
THEY GOT ROLLED OUT COUNTY BY

1368
00:49:17,754 --> 00:49:18,989
COUNTY THEN RELATE TO LOWER RISK

1369
00:49:19,056 --> 00:49:20,324
OF DIABETES LATER IN LIFE, AND I

1370
00:49:20,390 --> 00:49:21,625
THINK WE SHOULD DO THAT SAME

1371
00:49:21,692 --> 00:49:24,027
STUDY WITH COGNITION.

1372
00:49:24,094 --> 00:49:26,063
WE NEED TO REFORM POLICE

1373
00:49:26,129 --> 00:49:27,364
FUNDING, DEMILITARIZE AND

1374
00:49:27,431 --> 00:49:28,632
REINVEST THAT IN COMMUNITY

1375
00:49:28,699 --> 00:49:31,134
SAFETY PROGRAMS, BECAUSE

1376
00:49:31,201 --> 00:49:33,670
INCARCERATION AND POLICING IS A

1377
00:49:33,737 --> 00:49:35,839
STRESSOR RELATED -- AND PEOPLE

1378
00:49:35,906 --> 00:49:38,575
ARE WORKING ON HOW TO SHOW THAT

1379
00:49:38,642 --> 00:49:40,377
IT'S RELATED TO COGNITION, IT IS

1380
00:49:40,444 --> 00:49:45,082
RELATED TO OTHER HEALTH AND

1381
00:49:45,148 --> 00:49:46,383
WELLNESS OUTCOMES.

1382
00:49:46,450 --> 00:49:48,151
LOWER ELIGIBILITY AGE FOR

1383
00:49:48,218 --> 00:49:49,386
MEDICARE, AND FINALLY I THINK

1384
00:49:49,453 --> 00:49:53,724
NIA IS DOING A WON TER FULL JOBF

1385
00:49:53,790 --> 00:49:55,992
THIS, WHICH IS TO TRAIN AN

1386
00:49:56,059 --> 00:49:57,227
ANTI-RACIST AND DIVERSE RESEARCH

1387
00:49:57,294 --> 00:49:57,928
AND HEALTHCARE WORKFORCE.

1388
00:49:57,994 --> 00:49:58,462
THANK YOU.

1389
00:49:58,528 --> 00:50:01,431
[APPLAUSE]

1390
00:50:01,498 --> 00:50:02,866
>> WE DO HAVE A COUPLE QUESTIONS

1391
00:50:02,933 --> 00:50:04,267
ONLINE BUT I WOULD LOVE ANYONE

1392
00:50:04,334 --> 00:50:05,635
FROM HERE TO PLEASE GO TO THE

1393
00:50:05,702 --> 00:50:07,371
MICROPHONE.

1394
00:50:07,437 --> 00:50:14,378
I'LL REPEAT THE CME CODE, 50124.

1395
00:50:14,444 --> 00:50:15,078
50124.

1396
00:50:15,145 --> 00:50:16,513
DR. GOTTESMAN.

1397
00:50:16,580 --> 00:50:18,782
>> HI, THANK YOU, JEN, FOR THAT

1398
00:50:18,849 --> 00:50:19,249
WONDERFUL TALK.

1399
00:50:19,316 --> 00:50:21,017
I WAS JUST WONDERING IF YOU

1400
00:50:21,084 --> 00:50:22,119
COULD SORT OF SPECULATE ON WHAT

1401
00:50:22,185 --> 00:50:23,653
YOU THINK THE MECHANISMS ARE

1402
00:50:23,720 --> 00:50:25,322
LINKING THE SOCIAL AND

1403
00:50:25,389 --> 00:50:26,423
STRUCTURAL DETERMINANTS WITH THE

1404
00:50:26,490 --> 00:50:27,591
BIOLOGICAL CHANGES THAT YOU

1405
00:50:27,657 --> 00:50:27,858
DESCRIBED.

1406
00:50:27,924 --> 00:50:29,893
I KNOW THERE'S BEEN SOME WORK

1407
00:50:29,960 --> 00:50:32,028
DESCRIBING SORT OF INCREASED

1408
00:50:32,095 --> 00:50:33,764
INFLAMMATORY MARKERS THAT

1409
00:50:33,830 --> 00:50:35,198
PERHAPS THAT MIGHT

1410
00:50:35,265 --> 00:50:35,932
MECHANISTICALLY LINK THE TWO.

1411
00:50:35,999 --> 00:50:37,100
I'M JUST CURIOUS ABOUT YOUR

1412
00:50:37,167 --> 00:50:37,567
THOUGHTS.

1413
00:50:37,634 --> 00:50:38,502
>> RIGHT.

1414
00:50:38,568 --> 00:50:41,138
WELL, I THINK THAT, YOU KNOW,

1415
00:50:41,204 --> 00:50:45,242
WE'RE WORKING ON FINDING THAT --

1416
00:50:45,308 --> 00:50:47,310
WE'RE WORKING ON MAKING THOSE

1417
00:50:47,377 --> 00:50:47,611
CONNECTIONS.

1418
00:50:47,677 --> 00:50:52,983
PART OF IT IS RECOGNIZING THAT,

1419
00:50:53,049 --> 00:51:00,724
YOU KNOW, THAT SOME OF THESE

1420
00:51:00,791 --> 00:51:03,093
EXPOSURES, IT'S BETTER TO STUDY

1421
00:51:03,160 --> 00:51:04,094
THEM WHEN THEY'RE HAPPENING,

1422
00:51:04,161 --> 00:51:05,095
RIGHT?

1423
00:51:05,162 --> 00:51:07,097
SO THOSE SCHOOL-BASED COHORTS OR

1424
00:51:07,164 --> 00:51:08,832
THOSE ADOLESCENT COHORTS,

1425
00:51:08,899 --> 00:51:11,768
TRACKING PEOPLE OVER TIME, WHERE

1426
00:51:11,835 --> 00:51:13,570
WE HAVE LONGITUDAL BIOMARKERS

1427
00:51:13,637 --> 00:51:16,973
THAT CAN LOOK AT INFLAMMATION

1428
00:51:17,040 --> 00:51:20,343
BUT ALSO THOSE SOCIAL AND

1429
00:51:20,410 --> 00:51:22,045
STRUCTURAL FACTORS.

1430
00:51:22,112 --> 00:51:24,014
INCOME SEEMS TO HAVE A VERY

1431
00:51:24,080 --> 00:51:25,982
STRONG EFFECT ON MEMORY SLOPE

1432
00:51:26,049 --> 00:51:32,222
OVER TIME, BUT NOT SO MUCH ON

1433
00:51:32,289 --> 00:51:33,924
INTERCEPT, WHEREAS LIKE

1434
00:51:33,990 --> 00:51:35,859
FAMILY -- CHILDHOOD SES HAS A

1435
00:51:35,926 --> 00:51:40,263
MAJOR IMPACT ON INTERCEPT, BUT

1436
00:51:40,330 --> 00:51:43,266
NOT SO MUCH ON SLOPE.

1437
00:51:43,333 --> 00:51:46,136
SO I THINK OCCUPATION IS ONE

1438
00:51:46,203 --> 00:51:50,807
LIKELY MECHANISM, FAMILY

1439
00:51:50,874 --> 00:51:54,411
FORMATION AND THE STRESSES THAT

1440
00:51:54,478 --> 00:51:59,049
GO ALONG WITH SUPPORTING A

1441
00:51:59,115 --> 00:52:00,484
FAMILY, THAT CAN GO ALONG WITH

1442
00:52:00,550 --> 00:52:01,384
SUPPORTING A FAMILY IF YOU ARE

1443
00:52:01,451 --> 00:52:03,787
LIVING IN POVERTY OR ANOTHER

1444
00:52:03,854 --> 00:52:08,625
POSSIBLE, YOU KNOW, MECHANISM,

1445
00:52:08,692 --> 00:52:10,126
SO IF YOUR QUESTION IS WHAT ARE

1446
00:52:10,193 --> 00:52:12,562
THE SOCIAL AND STRUCTURAL

1447
00:52:12,629 --> 00:52:17,300
DRIVERS OF THOSE BIOLOGICAL

1448
00:52:17,367 --> 00:52:20,504
FACTORS, I THINK THAT WE'RE NOT

1449
00:52:20,570 --> 00:52:25,175
THERE YET, BUT I THINK THESE

1450
00:52:25,242 --> 00:52:30,914
LONGITUDAL STUDIES THAT ARE NOW

1451
00:52:30,981 --> 00:52:33,216
EMERGING, THAT HAVE LONGITUDAL

1452
00:52:33,283 --> 00:52:34,084
BIOMARKER COLLECTION, ARE GOING

1453
00:52:34,150 --> 00:52:35,218
TO HELP.

1454
00:52:35,285 --> 00:52:36,119
>> OKAY.

1455
00:52:36,186 --> 00:52:37,320
MAYBE A QUESTION FROM ONLINE

1456
00:52:37,387 --> 00:52:39,956
THEN.

1457
00:52:40,023 --> 00:52:41,691
IS THE RISE IN THE RATES OF

1458
00:52:41,758 --> 00:52:43,393
DEMENTIA IN LOW AND MIDDLE

1459
00:52:43,460 --> 00:52:44,928
INCOME COUNTRIES DIRECTLY

1460
00:52:44,995 --> 00:52:49,399
RELATED TO THE RISE OF LIFE

1461
00:52:49,466 --> 00:52:50,767
EXPECTANCY OR ARE OTHER FACTORS

1462
00:52:50,834 --> 00:52:51,101
INVOLVED?

1463
00:52:51,167 --> 00:52:53,603
I ASK BECAUSE GDP IS NOT A

1464
00:52:53,670 --> 00:52:54,804
PERFECT PREDICTOR OF LIFE

1465
00:52:54,871 --> 00:52:55,105
EXPECTANCY.

1466
00:52:55,171 --> 00:52:59,009
>> YEAH, I THINK THAT IT'S BOTH

1467
00:52:59,075 --> 00:53:02,712
LIFE EXPECTANCY AND ALSO THE

1468
00:53:02,779 --> 00:53:05,582
AGING OF THE POPULATION IN

1469
00:53:05,649 --> 00:53:06,149
GENERAL, JUST --

1470
00:53:06,216 --> 00:53:06,950
>> COHORT?

1471
00:53:07,017 --> 00:53:08,451
>> OF THE COHORT, RIGHT, SO

1472
00:53:08,518 --> 00:53:12,188
THERE ARE JUST MORE OLDER

1473
00:53:12,255 --> 00:53:14,691
PEOPLE, THAT THE BALANCE BETWEEN

1474
00:53:14,758 --> 00:53:16,293
OLDER PEOPLE AND YOUNGER PEOPLE

1475
00:53:16,359 --> 00:53:19,963
IS SHIFTING TOWARDS OLDER PEO

1476
00:53:20,030 --> 00:53:20,196
PEOPLE.

1477
00:53:20,263 --> 00:53:21,565
BUT SINCE AGE IS THE NUMBER ONE

1478
00:53:21,631 --> 00:53:25,101
RISK FACTOR, THAT'S WHAT'S

1479
00:53:25,168 --> 00:53:25,869
HAPPENING.

1480
00:53:25,936 --> 00:53:28,672
>> OKAY.

1481
00:53:28,738 --> 00:53:30,206
THAT'S AN NIH QUESTION HERE.

1482
00:53:30,273 --> 00:53:31,841
YOUR WORK SUGGESTED EDUCATION IN

1483
00:53:31,908 --> 00:53:33,310
GENERAL IS PROTECTIVE.

1484
00:53:33,376 --> 00:53:35,412
HAVE YOU SEEN ANY CORRELATION

1485
00:53:35,478 --> 00:53:37,180
WITH SPECIFIC TYPES OF EDUCATION

1486
00:53:37,247 --> 00:53:42,118
SUCH AS STEM VERSUS NON-STEM?

1487
00:53:42,185 --> 00:53:43,453
>> SO ONE OF THE STUDIES I'M

1488
00:53:43,520 --> 00:53:44,788
WORKING WITH NOW, HIGH SCHOOL

1489
00:53:44,854 --> 00:53:46,723
AND BEYOND, ONE OF THEIR KEY

1490
00:53:46,790 --> 00:53:52,128
FINDINGS IS THAT STEM COURSES,

1491
00:53:52,195 --> 00:53:53,563
THAT WHEN HIGH SCHOOL STUDENTS

1492
00:53:53,630 --> 00:53:56,099
WERE ABLE TO -- TOOK STEM

1493
00:53:56,166 --> 00:53:58,301
COURSES THEMSELVES, AND

1494
00:53:58,368 --> 00:54:00,170
OBVIOUSLY THEY TOOK THEM BECAUSE

1495
00:54:00,236 --> 00:54:01,471
THEY WERE AVAILABLE, YOU KNOW,

1496
00:54:01,538 --> 00:54:05,475
AT THE SCHOOL, THEY CORRELATE

1497
00:54:05,542 --> 00:54:07,877
WITH SORT OF THE HUMAN CAPITAL

1498
00:54:07,944 --> 00:54:11,581
OUTCOMES, YOU KNOW, EARNINGS,

1499
00:54:11,648 --> 00:54:15,185
OCCUPATIONAL STATUS, AND THE

1500
00:54:15,251 --> 00:54:17,020
THINGS THAT ECONOMISTS USUALLY

1501
00:54:17,087 --> 00:54:19,656
MEASURE.

1502
00:54:19,723 --> 00:54:22,359
THAT TURNS OUT AS WE'RE SORT OF

1503
00:54:22,425 --> 00:54:25,328
DIVING INTO THE DATA, NOT TO BE

1504
00:54:25,395 --> 00:54:28,898
AS STRONG A PREDICTOR OF

1505
00:54:28,965 --> 00:54:32,068
COGNITION AS ONE WOULD THINK

1506
00:54:32,135 --> 00:54:35,138
THROUGH THOSE MECHANISMS OF

1507
00:54:35,205 --> 00:54:37,240
BETTER OCCUPATION, HIGHER

1508
00:54:37,307 --> 00:54:38,608
EARNINGS.

1509
00:54:38,675 --> 00:54:41,945
INSTEAD, YOU KNOW, THE TWO

1510
00:54:42,012 --> 00:54:43,279
THINGS IN THE HIGH SCHOOL AND

1511
00:54:43,346 --> 00:54:45,081
BEYOND COHORT THAT ARE REALLY --

1512
00:54:45,148 --> 00:54:47,183
SEEM TO BE DRIVING AND I HOPE

1513
00:54:47,250 --> 00:54:48,485
MAYBE NEXT TIME I COME AND TALK

1514
00:54:48,551 --> 00:54:49,786
I'LL BE ABLE TO SHOW YOU ALL

1515
00:54:49,853 --> 00:54:53,590
THOSE DATA, WHICH IS FAMILY SES

1516
00:54:53,657 --> 00:54:58,995
REALLY, REALLY DRIVES WHERE YOU

1517
00:54:59,062 --> 00:54:59,462
GO TO SCHOOL.

1518
00:54:59,529 --> 00:55:01,631
IT IS EXTREMELY, YOU KNOW,

1519
00:55:01,698 --> 00:55:02,932
STRONGLY RELATED TO THE QUALITY

1520
00:55:02,999 --> 00:55:05,435
OF SCHOOL THAT YOU GO TO.

1521
00:55:05,502 --> 00:55:06,903
SO ONCE YOU SORT OF ADJUST IN

1522
00:55:06,970 --> 00:55:11,708
YOUR MODELS OF FAMILY SES, THE

1523
00:55:11,775 --> 00:55:15,578
EFFECTS OF SKOLL, YOU  SCHOOL, E

1524
00:55:15,645 --> 00:55:18,014
SCHOOL QUALITY VARIABLES,

1525
00:55:18,081 --> 00:55:18,548
BASICALLY FLATTEN.

1526
00:55:18,615 --> 00:55:19,649
AND THAT ALL LEADS TO

1527
00:55:19,716 --> 00:55:20,150
ATTAINMENT.

1528
00:55:20,216 --> 00:55:21,418
SO ATTAINMENT IS REALLY THE

1529
00:55:21,484 --> 00:55:22,852
THING, THAT THE BETTER YOU DO IN

1530
00:55:22,919 --> 00:55:23,920
SCHOOL, THE HIGHER QUALITY

1531
00:55:23,987 --> 00:55:26,122
SCHOOL THAT YOU GET, YOU HAVE A

1532
00:55:26,189 --> 00:55:27,223
HIGHER ATTAINMENT.

1533
00:55:27,290 --> 00:55:29,826
AND THAT CREDENTIAL SORT OF THEN

1534
00:55:29,893 --> 00:55:31,594
GOES A LONG WAY THROUGHOUT LIFE.

1535
00:55:31,661 --> 00:55:34,664
I THINK IT'S A VERY POWERFUL

1536
00:55:34,731 --> 00:55:36,199
THING.

1537
00:55:36,266 --> 00:55:38,535
SO WHILE YEARS AGO I STARTED OUT

1538
00:55:38,601 --> 00:55:40,203
TRYING TO ASK WELL, IT'S NOT

1539
00:55:40,270 --> 00:55:41,604
JUST ATTAINMENT, IT'S ABOUT

1540
00:55:41,671 --> 00:55:42,405
QUALITY, BUT THAT QUALITY THEN

1541
00:55:42,472 --> 00:55:43,840
LEADS TO THE ATTAINMENT, AND

1542
00:55:43,907 --> 00:55:45,742
THAT ATTAINMENT IS THE THING,

1543
00:55:45,809 --> 00:55:46,810
THE CREDENTIAL AND THAT

1544
00:55:46,876 --> 00:55:50,580
EXPERIENCE IS THE THING THAT

1545
00:55:50,647 --> 00:55:52,082
COGNITIVELY, I THINK, HAS THE

1546
00:55:52,148 --> 00:55:55,051
MOST EFFECT IN COHORTS LIKE HIGH

1547
00:55:55,118 --> 00:55:56,152
SCHOOL AND BEYOND THAT WENT TO

1548
00:55:56,219 --> 00:55:57,620
HIGH SCHOOL IN 1980.

1549
00:55:57,687 --> 00:55:59,889
>> OKAY.

1550
00:55:59,956 --> 00:56:01,658
SO WHILE YOU DIDN'T FIND MEAN

1551
00:56:01,725 --> 00:56:03,393
DIFFERENCES IN BLOOD BIOMARKERS

1552
00:56:03,460 --> 00:56:04,994
BY RACE IN WHICAP --

1553
00:56:05,061 --> 00:56:05,628
>> I DID NOT.

1554
00:56:05,695 --> 00:56:08,598
>> RIGHT, WHILE YOU DID NOT DO

1555
00:56:08,665 --> 00:56:10,300
THAT, THERE WAS A MUCH WIDER

1556
00:56:10,366 --> 00:56:11,634
RANGE OF MANY OF THEM IN THE

1557
00:56:11,701 --> 00:56:14,170
BLACK AND LATINX GROUPS COMPARED

1558
00:56:14,237 --> 00:56:14,671
TO WHITES.

1559
00:56:14,738 --> 00:56:15,905
CAN YOU SPEAK TO WHY THAT MIGHT

1560
00:56:15,972 --> 00:56:16,306
BE?

1561
00:56:16,372 --> 00:56:17,941
>> BECAUSE IT'S REALLY HARD TO

1562
00:56:18,007 --> 00:56:20,443
FIND WHITE PEOPLE IN THE

1563
00:56:20,510 --> 00:56:21,745
OFFSPRING STUDY.

1564
00:56:21,811 --> 00:56:23,346
SO I MEAN, IT'S REALLY JUST A

1565
00:56:23,413 --> 00:56:27,851
MATTER OF SAMPLE SIZE.

1566
00:56:27,917 --> 00:56:29,352
THE FAMILIES IN WHITE CAB WHO

1567
00:56:29,419 --> 00:56:31,488
ARE BLACK AND LATINX HAVE MORE

1568
00:56:31,554 --> 00:56:32,922
CHILDREN, AND THE WHITE PEOPLE,

1569
00:56:32,989 --> 00:56:35,225
AT LEAST IN THE BEGINNING,

1570
00:56:35,291 --> 00:56:38,361
BEFORE COVID WHEN WE WERE REALLY

1571
00:56:38,428 --> 00:56:39,195
COLLECTING A LOT OF BLOOD AND

1572
00:56:39,262 --> 00:56:41,030
NOW IT GOT BACK ONLINE

1573
00:56:41,097 --> 00:56:42,899
OBVIOUSLY, BUT WE SENT THOSE

1574
00:56:42,966 --> 00:56:47,170
SAMPLES OUT DURING COVID, AND SO

1575
00:56:47,237 --> 00:56:49,405
THE WHITE -- THE CHILDREN OF THE

1576
00:56:49,472 --> 00:56:52,041
WHITE PARTICIPANTS IN WHICAP ARE

1577
00:56:52,108 --> 00:56:53,576
MOST LIKELY TO HAVE MOVED AWAY,

1578
00:56:53,643 --> 00:56:55,378
OUT OF THE AREA.

1579
00:56:55,445 --> 00:57:00,383
AND SO THEY WERE HARDER TO FIND,

1580
00:57:00,450 --> 00:57:02,118
AND SO WE'RE ON OUR WAY TO GET

1581
00:57:02,185 --> 00:57:03,219
THEIR BLOOD NOW, BUT THAT'S THE

1582
00:57:03,286 --> 00:57:05,989
REASON WHY YOU SEE THAT SORT OF

1583
00:57:06,055 --> 00:57:08,591
VARIABILITY ISSUE.

1584
00:57:08,658 --> 00:57:10,426
IT'S A SAMPLE SIZE ISSUE.

1585
00:57:10,493 --> 00:57:13,029
>> JEN, THERE'S SO MANY

1586
00:57:13,096 --> 00:57:14,631
QUESTIONS THAT COME TO MIND, BUT

1587
00:57:14,697 --> 00:57:18,902
ONE OF THEM IS, SO WE SEE THAT

1588
00:57:18,968 --> 00:57:20,303
THE -- ESPECIALLY OVER THE LAST

1589
00:57:20,370 --> 00:57:23,106
TWO DECADES, THERE IS A WIDENING

1590
00:57:23,173 --> 00:57:24,374
OF THE DIFFERENCE BETWEEN THE

1591
00:57:24,440 --> 00:57:25,175
POOR AND THE RICH.

1592
00:57:25,241 --> 00:57:28,478
I MEAN, IT'S VERY WORRISOME THAT

1593
00:57:28,545 --> 00:57:32,749
SO MANY MORE PEOPLE ARE UNDER

1594
00:57:32,816 --> 00:57:34,551
THE -- OF POVERTY AND THERE ARE

1595
00:57:34,617 --> 00:57:36,052
SO MANY MORE PEOPLE THAT ARE NOT

1596
00:57:36,119 --> 00:57:37,587
ON THE THRESHOLD OF POVERTY BUT

1597
00:57:37,654 --> 00:57:41,391
STILL DON'T MAKE IT, AND SO

1598
00:57:41,457 --> 00:57:42,692
BASED ON WHAT YOU SEE IN YOUR

1599
00:57:42,759 --> 00:57:46,129
STUDY, YOU THINK THAT THE RISE N

1600
00:57:46,196 --> 00:57:47,997
THE RISK OF DEMENTIA THAT WILL

1601
00:57:48,064 --> 00:57:52,101
BE DUE TO THIS INCREASING

1602
00:57:52,168 --> 00:57:54,704
STRESS, INCREASING ACCESS TO

1603
00:57:54,771 --> 00:57:58,041
EDUCATION, INCREASING -- REDUCED

1604
00:57:58,107 --> 00:58:00,577
ACCESS OF OUR CARE, AND I THINK

1605
00:58:00,643 --> 00:58:01,544
THAT THAT'S SOMETHING THAT WE

1606
00:58:01,611 --> 00:58:04,380
DON'T TALK ABOUT, BUT IT'S

1607
00:58:04,447 --> 00:58:05,882
LIKELY THAT IT WILL HAVE HEALTH

1608
00:58:05,949 --> 00:58:06,749
CONSEQUENCE IN THE POPULATION.

1609
00:58:06,816 --> 00:58:11,354
>> I THINK THERE ARE MANY

1610
00:58:11,421 --> 00:58:12,455
FACTORS WORKING TOGETHER, AND

1611
00:58:12,522 --> 00:58:13,723
THAT'S WHY IT'S SO IMPORTANT FOR

1612
00:58:13,790 --> 00:58:16,526
US TO BE ABLE TO MEASURE

1613
00:58:16,593 --> 00:58:17,861
THOSE -- MEASURE ALL THESE RISK

1614
00:58:17,927 --> 00:58:20,563
FACTORS WITH THE RESILIENCE

1615
00:58:20,630 --> 00:58:21,865
FACTORS, SO ONE OF THE THINGS

1616
00:58:21,931 --> 00:58:24,033
THAT HAPPENED WITH THE WHICAP

1617
00:58:24,100 --> 00:58:26,436
STUDY THAT I DIDN'T MENTION IS

1618
00:58:26,502 --> 00:58:28,438
THAT IN THE LATER BORN COHORT,

1619
00:58:28,504 --> 00:58:29,606
THERE WAS A MUCH HIGHER

1620
00:58:29,672 --> 00:58:31,007
PREVALENCE OF DIABETES AND

1621
00:58:31,074 --> 00:58:32,375
HYPERTENSION THAN IN THE EARLIER

1622
00:58:32,442 --> 00:58:35,245
BORN COHORT.

1623
00:58:35,311 --> 00:58:37,547
BUT THE EFFECT OF HYPERTENSION

1624
00:58:37,614 --> 00:58:39,649
AND DIABETES SORT OF IN

1625
00:58:39,716 --> 00:58:41,918
EXPLAINING THOSE COHORT

1626
00:58:41,985 --> 00:58:44,721
DIFFERENCES WAS NOTHING.

1627
00:58:44,787 --> 00:58:47,023
AND ALSO JUST IN EXPLAINING THE

1628
00:58:47,090 --> 00:58:51,527
RISK OF DEVELOPING DEMENTIA WAS

1629
00:58:51,594 --> 00:58:53,796
LESS, LESS SO IN THE LATER BORN

1630
00:58:53,863 --> 00:58:54,831
COHORT, BECAUSE THEY'RE BEING

1631
00:58:54,898 --> 00:58:57,233
TREATED MORE EFFECTIVELY.

1632
00:58:57,300 --> 00:58:58,968
DID A DOCTOR EVER TELL YOU YOU

1633
00:58:59,035 --> 00:59:00,236
HAVE HYPERTENSION, DIABETES,

1634
00:59:00,303 --> 00:59:01,137
THAT'S ESSENTIALLY WHAT THOSE

1635
00:59:01,204 --> 00:59:02,872
QUESTIONS ARE BASED ON, AND IN

1636
00:59:02,939 --> 00:59:03,940
ADDITION TO WHETHER THEY'RE

1637
00:59:04,007 --> 00:59:06,009
TAKING MEDICATIONS, AND MANY

1638
00:59:06,075 --> 00:59:07,644
MORE PEOPLE WERE BEING

1639
00:59:07,710 --> 00:59:09,078
EASKTTIVELY TREATED IN THE LATER

1640
00:59:09,145 --> 00:59:10,680
BORN COHORT THAN IN THE EARLIER

1641
00:59:10,747 --> 00:59:11,648
BORN COHORTS.

1642
00:59:11,714 --> 00:59:13,850
SO EVEN THOUGH THE PREVALENCE IS

1643
00:59:13,917 --> 00:59:15,351
MUCH HIGHER IN THE LATER BORN

1644
00:59:15,418 --> 00:59:17,954
COHORT, THE TREATMENT IS BETTER.

1645
00:59:18,021 --> 00:59:20,156
SO I MEAN, I'M NOT SAYING LET'S

1646
00:59:20,223 --> 00:59:22,425
NOT WORRY ABOUT IT.

1647
00:59:22,492 --> 00:59:27,764
I'M SAYING I AGREE WITH YOU THAT

1648
00:59:27,830 --> 00:59:29,632
THONE THING I THINK WOULD BE VEY

1649
00:59:29,699 --> 00:59:33,803
INTERESTING TO EXPLORE IS

1650
00:59:33,870 --> 00:59:36,873
WHETHER THE DISPARITIES ARE MORE

1651
00:59:36,940 --> 00:59:39,542
SENSITIVE TO ABSOLUTE SORT OF --

1652
00:59:39,609 --> 00:59:40,877
SORT OF ABSOLUTE GAPS OR

1653
00:59:40,944 --> 00:59:44,514
ABSOLUTE DISPARITIES, ABSOLUTE

1654
00:59:44,580 --> 00:59:48,918
INEQUALITIES, OR WHETHER THEY

1655
00:59:48,985 --> 00:59:50,219
ARE SENSITIVE TO SORT OF

1656
00:59:50,286 --> 00:59:52,088
EVERYONE IS GOING UP BUT THOSE

1657
00:59:52,155 --> 00:59:54,357
INEQUALITIES ARE REMAINING --

1658
00:59:54,424 --> 00:59:55,892
YOU KNOW, THOSE GAPS ARE

1659
00:59:55,959 --> 00:59:56,626
REMAINING THE SAME.

1660
00:59:56,693 --> 01:00:00,363
AND I THINK COHORT DATA LIKE

1661
01:00:00,430 --> 01:00:01,664
THAT COLLECTED IN THE HRS WILL

1662
01:00:01,731 --> 01:00:02,932
BE ABLE TO HELP US UNDERSTAND

1663
01:00:02,999 --> 01:00:03,866
THAT.

1664
01:00:03,933 --> 01:00:05,668
>> AGAIN, FANTASTIC TALK.

1665
01:00:05,735 --> 01:00:07,937
IN TERMS OF YOUR GUIDANCE FOR

1666
01:00:08,004 --> 01:00:10,106
THE KIND OF RESEARCH WE CAN DO

1667
01:00:10,173 --> 01:00:12,742
TOWARD THE FUTURE, BIG

1668
01:00:12,809 --> 01:00:15,979
DISCREPANCY AS YOU'RE POINTING

1669
01:00:16,045 --> 01:00:17,513
OUT FOR COMMUNITY-BASED STUDIES

1670
01:00:17,580 --> 01:00:21,117
AND CLINIC BASED STUDIES, FOR A

1671
01:00:21,184 --> 01:00:23,152
TIME, BUT TO ASK, NOW THAT WE

1672
01:00:23,219 --> 01:00:25,888
HAVE BLOOD BIOMARKERS, DIGITAL

1673
01:00:25,955 --> 01:00:27,690
BIOMARKERS, SO MANY MORE

1674
01:00:27,757 --> 01:00:30,026
CREATIVE WAYS TO MONITOR

1675
01:00:30,093 --> 01:00:32,295
BIOLOGIC AND BEHAVIORAL

1676
01:00:32,362 --> 01:00:33,963
FUNCTIONS, THAT GAP OUGHT TO BE

1677
01:00:34,030 --> 01:00:35,098
CLOSED, WE OUGHT TO BE ABLE TO

1678
01:00:35,164 --> 01:00:36,666
DO BETTER, DON'T YOU THINK, IN

1679
01:00:36,733 --> 01:00:38,067
THE POPULATION STUDIES THAN

1680
01:00:38,134 --> 01:00:39,102
WE'VE BEEN ABLE TO SO FAR?

1681
01:00:39,168 --> 01:00:40,503
>> I THINK PART OF THAT IS GOING

1682
01:00:40,570 --> 01:00:42,038
TO TAKE A RETOOLING OF THE

1683
01:00:42,105 --> 01:00:44,974
INVESTIGATORS THAT -- YOU KNOW,

1684
01:00:45,041 --> 01:00:45,842
MY COLLEAGUES AND ME.

1685
01:00:45,908 --> 01:00:50,279
HE WITH NWE NEED TO RETOOL OURSO

1686
01:00:50,346 --> 01:00:54,217
BE BETTER PREAC PREPARED FOR

1687
01:00:54,283 --> 01:00:56,486
COMMUNITY-BASED STUDIES AND TO

1688
01:00:56,552 --> 01:00:58,988
ROLL OUT BIOLOGICAL -- IT IS

1689
01:00:59,055 --> 01:01:00,189
ACTUALLY EXPENSIVE, RICHARD, TO

1690
01:01:00,256 --> 01:01:03,359
DO, JUST TO LET YOU KNOW.

1691
01:01:03,426 --> 01:01:06,396
SO YOU KNOW, I THINK -- I THINK

1692
01:01:06,462 --> 01:01:08,131
YOU'RE ABSOLUTELY RIGHT, THAT I

1693
01:01:08,197 --> 01:01:10,099
FEEL VERY HOPEFUL ABOUT IT, VERY

1694
01:01:10,166 --> 01:01:12,702
EXCITED ABOUT IT, BUT I THINK

1695
01:01:12,769 --> 01:01:15,204
THERE NEEDS TO BE A RECKONING

1696
01:01:15,271 --> 01:01:16,472
ESSENTIALLY WITH THOSE STUDIES

1697
01:01:16,539 --> 01:01:19,242
THAT OVER TIME HAVEN'T REALLY,

1698
01:01:19,308 --> 01:01:22,812
YOU KNOW, BEEN ABLE TO

1699
01:01:22,879 --> 01:01:26,315
DIVERSIFY, AND A RETOOLING OF

1700
01:01:26,382 --> 01:01:27,850
THE TEAMS THAT ARE ASSOCIATED

1701
01:01:27,917 --> 01:01:29,352
WITH THEM BECAUSE I THINK SOME

1702
01:01:29,419 --> 01:01:31,921
VERY EXCITING SCIENCE CAN HAPPEN

1703
01:01:31,988 --> 01:01:34,590
WHEN WE MERGE THOSE SORT OF

1704
01:01:34,657 --> 01:01:36,859
POPULATION-BASED STUDIES WITH

1705
01:01:36,926 --> 01:01:43,800
POPULATION BIOMARKER TECHNOLOGY.

1706
01:01:43,866 --> 01:01:45,168
>> NO MORE QUESTIONS OR

1707
01:01:45,234 --> 01:01:45,501
COMMENTS?

1708
01:01:45,568 --> 01:01:47,036
JUST TO THANK YOU, THIS IS JUST

1709
01:01:47,103 --> 01:01:48,671
A TOUR DEFORCE IN DEMONSTRATING

1710
01:01:48,738 --> 01:01:51,474
TO US HOW ONE CAN JOIN

1711
01:01:51,541 --> 01:01:53,109
COMMUNITY-BASED SOCIAL

1712
01:01:53,176 --> 01:01:55,078
DETERMINANTS, BIOLOGICAL

1713
01:01:55,144 --> 01:01:55,978
DETERMINANTS, THEIR CONVERGENCE

1714
01:01:56,045 --> 01:01:58,347
AND THE INSPIRATION PROVIDED TO

1715
01:01:58,414 --> 01:01:59,882
ALL OF US.

1716
01:01:59,949 --> 01:02:00,750
FLORENCE MAHONEY WOULD BE PROUD.

1717
01:02:00,817 --> 01:02:01,517
THANK YOU SO MUCH.

1718
01:02:01,584 --> 01:02:01,951
>> THANK YOU.

1719
01:02:02,018 --> 01:02:12,195
[APPLAUSE]