The physical and mental consequences of racism 4:12
(CNN) - Chronic stress can change your brain. Experiencing racism could make it worse.
Racial discrimination can increase stress, lead to health problems and hinder the cognitive function of black women, according to a new study.
Black women who frequently experienced daily racism, including racial slurs, poor store service, or stereotypes, had 2.75 times the risk of subjective cognitive malfunction than women who experienced lower levels of daily racism.
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Cognitive function refers to a person's mental ability to learn, think, reason, solve problems, make decisions, remember, and pay attention.
The study was published Tuesday in the journal Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring.
Those who found the highest degrees of institutional racism, when it came to work, housing, or the police, were 2.66 times more likely to report cognitive malfunction than women who experienced institutional racism less frequently.
The findings were not "unexpected because we know that stressors have been linked to poor cognitive function, and experiences of racism are very large stressors in the lives of black people," said Lynn Rosenberg, lead author of the study and an epidemiologist. at the Slone Epidemiology Center at Boston University, and Professor of Epidemiology at the Boston University School of Public Health.
Rates of dementia and Alzheimer's disease, conditions that inhibit cognitive abilities, are higher in black people. Cases of racism have been linked to conditions that increase the risk of cognitive problems, including depression and sleep deprivation, so the researchers thought that frequent experiences of racism among black women could negatively affect their subjective thinking abilities. critically understand, follow conversations, or navigate.
"Depression and post-traumatic stress disorder (PTSD) can have long-term cognitive effects," said Dr. Danielle Hairston, a psychiatrist and associate professor at Howard University College of Medicine, who was not involved in the study.
"The emotional experience of psychological trauma (such as racism) can alter cognitive processes such as memory, attention, planning, and problem solving," said Hairston, who is also president of the Black Caucus of the American Psychiatric Association, at an email.
"Racism is a source of stress and depression, so I would expect racism to negatively affect cognitive functioning."
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Prejudice and cognitive health
The study included 17,323 women from the Black Women's Health Study, which was established in 1995. The goal of the longitudinal study was to understand what drives the highest disease rates among black women and what would improve their health.
While in their 40s, in 2009, women answered questions about how they experience daily and institutional racism. Among their daily experiences, they reported receiving worse service than other people in restaurants and shops, being treated as unintelligent and experiencing other people fearing them.
They also reported experiences of institutional racism: being treated unfairly because of their race in circumstances that include work; rent or buy a house; dealing with the police and the courts; school; and medical care.
At age 55 and older, in 2015, women answered questions over the phone about remembering things like recent events or a short list of items, and whether they had difficulty understanding spoken instructions or plot lines on television shows.
The more women reported racism during their daily lives, the worse their cognitive abilities were.
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How racism could affect the brain
The effect of discriminatory experiences on cognitive function could be in the hippocampus, the brain's storage unit for long-term memories, according to the study.
Because the hippocampus also regulates emotion and stress, it has a high concentration of receptors that are the main binding sites for cortisol, the stress hormone: these receptors detect stress and communicate the state to the rest of the body.
Chronic stress is associated with reduced hippocampal volume, and in older adults it has been associated with impaired hippocampal-dependent memory. The region is also among the first areas of the brain to decline when suffering from Alzheimer's disease, which black people have a higher risk of having than white people.
Among women who experienced the worst levels of racism, the researchers attributed between about 25% and 45% of their poor subjective cognitive functioning to depression and insomnia. Women who experience racism, according to the study, are more likely to be depressed and have trouble sleeping, which affects cognition.
Racism-related stress "can lead to conditions related to an increased risk of poor cognitive function, such as diabetes," Rosenberg said. "So it could be that there are these specific mechanisms that could be at play, or it could be just causing other conditions that are related to an increased risk of poor cognition," she said.
While the researchers found an association between discriminatory experiences and subjective cognitive failure, they did not control for potentially influencing factors, including women's odds of type 2 diabetes, physical activity, and hypertension.
"If you go to any Alzheimer's website, they always tell people to exercise and eat a healthy diet ... because these healthy behaviors seem to reduce the incidence of Alzheimer's disease," said Rosenberg. "That would be very encouraging if we discovered that this is the case in this cohort of women."
Highlighting social constructs as predictors of health
More studies are needed to examine whether exposure to racism accelerates the development of Alzheimer's dementia or raises the levels of biological markers that predict the condition, Rosenberg said. And more comprehensive and objective cognitive evaluations require deeper methods than a telephone control, Hairston said.
Recent attention to racial injustices and efforts to correct discrimination could be the reinforcement that health studies need to make a difference.
"People are much more willing to see the evidence of all the things that are happening and learn what experiences of racism do to people's lives in terms of housing, education, job opportunities and interactions with the police," Rosenberg said. "What our studies show (is that) we have looked at racism in relation to other conditions and I have no doubt that racism has an adverse effect on people's health."
“There are African American and other racial / ethnic minority patients who admit to a decreased ability to concentrate, remember things, etc. in the context of current racial and social unrest, ”Hairston said in an email.
"Health professionals must pay attention to these subjective reports."
Alzheimer disease
