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Seeking health justice for older African American people with Alzheimer’s Disease.
A Conversation with Laura Zahodne
Diversity Committee (DC): Can you tell me a little bit about you and about the work that you do?
Laura Zahodne: A lot of my work is about bio-psychosocial mechanisms that explain racial disparities in cognitive aging and Alzheimer's disease. That's kind of a bird's eye-view description.
DC: Can you tell me a little about a recent publication that you have that you're really excited about?
Laura Zahodne: In one recent publication we were interested in examining a specific cause or mechanisms by which racially patterned social stressors could influence cognitive health for older people. So, we tested whether elevated levels of C-reactive protein, which is a blood marker of inflammation, could mediate the association between older adults’ reports of everyday discrimination and their performance on an episodic memory test. So, what we found is that in this large nationally representative study, non-Hispanic Black older people reported more frequent experiences of discrimination than non-Hispanic Whites, and more frequent experiences of discrimination were associated with lower performance on an episodic memory task. And, that link between more discrimination experiences and lower memory performance was partially mediated by elevated levels of C-reactive proteins. They were partially mediated by inflammation.
DC: So, what are some of those practical meanings and implications of these findings?
Laura Zahodne: Well, I think that a goal of mine with this kind of work is to highlight the value of taking a bio-psychosocial approach to health inequalities. I think that researchers and policy makers would benefit from studying multiple levels of analysis— the social level, the biological level, the behavioral levels, to really get a more complete understanding of health inequalities, and to identify more potential intervention targets that could bring us closer to the goal of achieving health justice for older people.
DC: You talked about wanting researchers and policy makers to take a broader view of the health of older people. Is there a specific policy or specific impact that you would want this work to have?
Laura Zahodne: A lot of my audience are biomedical researchers. Who might not even be thinking about policy. So, kind of to them getting this idea that interventions could happen on other levels, not just individual levels. So especially if a lot of the social stressors that are impacting these downstream physical, uh, pathways, those interventions may better target more social levels, more policy levels, then individual, you know, designing a new drug or something like that. You can't, you know, if racially patterned stress is what's driving all of us, then you know, targeting someone's individual experience or reaction probably won't have as big of an impact as targeting the upstream generators of the stressors. So, I think having more of a dialogue between the people who are studying Alzheimer's disease and people who are, you know, aware of these larger issues, that would be a goal getting that dialogue started.
DC: What are the major sources of inspiration for you for the research that you do?
Laura Zahodne: I think one motivating factor for me has been the inadequacy of a purely biological model of Alzheimer's disease. I'm constantly inspired by the large number of resilient older people from all walks of life who maintain good cognitive health despite having Alzheimer's pathology in their brains. So, I want to know what is it about their individual experiences, and about the shared experiences of different social groups that can influence cognitive risk and resilience in late life.
DC: On a different note, what has been a major highlight or transformative moment for you and your work as a researcher and in doing your work?
Laura Zahodne: Mentoring is relatively newer for me as a junior faculty member, but even in the last several years, highlights come all the time—particularly when I see someone from the lab disseminating their research in a conference or in conversation with a small group of colleagues. They're harnessing and leveraging their experiences in the lab and the knowledge, and they're providing data to back up their theories. So, I really have seen how being a mentor is about helping up-and-coming researchers get a platform and hone their message so that when they get the platform they can take full advantage and make an impact. It's been very fun. A new job for me has been mentoring and seeing the fruits of, of mentoring.
DC: How about the transformative moment for you as a researcher?
Laura Zahodne: I think a lot of it is inspiring up-and-coming researchers… You know, sometimes you write an article and you wonder what is its impact. But, now I have people coming up to me and telling me that this made an impact, and that this one study, or this topic has inspired a project they’re doing with a group. That's where I've really seen the impact, is kind of helping build critical mass in work on the social determinants of cognitive health. You know, there's a huge body of research on the social determinants of health, but it has sort of been separate from Alzheimer's disease research. So, kind of bringing those together has been a goal.