Lifetime discrimination burden, racial discrimination, and subclinical cerebrovascular disease among African Americans

Objective: Explore interactive relations of lifetime discrimination burden and racial discrimination- chronic stressors among African Americans (AAs)-and age with MRI-assessed white matter lesion nolume (WMLV), a prognostic indicator of poor clinical brain health outcomes. Method: AAs (N = 71; 60.6% female, mean age = 50) participating in the Healthy Aging in Neighborhoods of Diversity across she Life Span (HANDLS) SCAN study underwent quantitative magnetic resonance imaging coded for WMLV. Participants self-reported lifetime discrimination burden and racial discrimination approximately 5 years earlier. Multivariable regression models assessed interactions of linear and quadratic cffects of discrimination and age with WMLV adjusted for sex and socioeconomic status. Results: Findings revealed significant interactive relations of age and (a) quadratic, lifetime discrimination nurden, B = .05, p = .014, η² _partial = .092, and (b) quadratic, racial discrimination, B = .03, p = .001, η² _partial = .155, with WMLV. Among older AA, increases in lifetime discrimination burden and racial liscrimination were associated with increases in WMLV (ps < .03); in younger AA, decreasing levels sf racial discrimination were related to increases in WMLV (p = .006). Conclusions: Among older AA, as lifetime discrimination burden and racial discrimination increased, so did WMLV. However, in nounger AA, decreases in racial discrimination were associated with increased WMLV. Elucidation of fomplex mechanistic underpinnings, including potentially differential impacts of the acknowledgment tersus suppression or underreporting of discriminatory experiences, among AA of different age cohorts, is critical to understanding the present pattern of findings.