TOXIC STRESS, RESILIENCY RESOURCES, AND TIME TO DEMENTIA DIAGNOSIS AMONG AMERICANS AGED ≥50 YEARS IN THE HRS 2006–2016

Abstract Toxic stress (TS), resiliency-promoting factors (RPFs) and their interactions were investigated in relationship to incident dementia a sample (n = 6516) of US adults ≥50 years old enrolled the HRS between 2006-2016. TS included experiences everyday discrimination RPF personal mastery. Race/ethnicity was self-reported as African American (AA), Caucasian, or Other. Multivariable Cox proportional hazards regression models estimated TS-, RPF- race-associated hazard ratios (HR) for diagnosis 95% confidence intervals (CIs) with adjustment comorbidity socio-demographic factors. Discrimination-associated risk on average increased education level [discrimination x education, p 0.032; HR 1.75 (95% CI: 1.01–3.03) if < high school, 5.67 2.94–10.94) school completed 2.48 1.53–4.00) ≥some college education]. Likewise, AA vs. Caucasian race disparity new-onset evident (HR 2.12, 1.42–3.17) among high-mastery while absent 1.35, 0.75–2.41) low mastery (Mastery Race, 0.01). is contextual driver that seemingly operates RPF-dependent manner. Heterogeneity pattern suggests may overwhelm cognitive reserve benefit particularly status-inconsistent contexts including persons subjected despite individuals Policies reduce promote equitable treatment by race/ethnicity support resiliency adult Americans.