Resilience and social support as correlates of dementia risk: insights from a biopsychosocial analysis of the All of Us dataset.

INTRODUCTION: Cognitive decline is a growing concern in the United States as the population ages. Risk scores such as the Cardiovascular Risk Factors Aging and Incidence of Dementia (CAIDE) have been validated to assess long-term risk for cognitive decline. The existing literature has primarily focused on biological risk factors; however, there is a growing emphasis on integrating psychological and social factors that may contribute to a greater risk of cognitive decline. METHODS: This study uses a large administrative data set (All of Us, N = 18,314) to examine biopsychosocial correlates of CAIDE risk score, examining psychological/behavioral correlates (e.g., anxiety, depression, sleep), social correlates (e.g., social support, loneliness), demographic correlates (e.g., sexual identity, race, gender), and biological correlates (e.g., pain). Correlates were examined using multiple linear regression with CAIDE score as the outcome, stratified by age group (<47 years, 47-53 years, >53 years). RESULTS: Results varied by age strata. Among Age < 47 years, in comparison to heterosexuals, gay participants had increased CAIDE scores. Among Age < 47 and Age > 53, Both non-Hispanic Black and Hispanic participants had higher CAIDE scores than White participants. Across age groups, depression, stress, and resilience were associated with CAIDE. Social support was significant among Age < 45. DISCUSSION: This analysis highlights the importance of framing risk for cognitive decline to incorporate both psychological and social determinants of health, in addition to biological risk factors.