Northwestern awarded $19.9 mil to study link between incarceration and Alzheimer’s

By Andrew Nellis
September, 10 2024

The National Institute on Aging has awarded Northwestern University $19.9 million to study how incarceration affects the risk of developing Alzheimer's disease and related dementias (ADRD). Titled Consequences of Incarceration on Health, Age-Related Conditions, and Risk Factors for ADRD, the project will follow a group of formerly incarcerated adults through median age 45, identifying specific risk factors of ADRD and, potentially, pinpointing strategies to bolster prevention.

Led by Linda A Teplin, PhD, Owen L. Coon Professor of Psychiatry and Behavioral Sciences and vice chair for Research in the Department of Psychiatry and Behavioral Sciences, the grant will extend the Northwestern Juvenile Project, a nearly three-decade study of health outcomes of incarcerated people.

“Our study addresses an enormous gap in the literature,” said Teplin, who is also a member of the Center for Community Health, which is housed within the Institute for Public Health and Medicine. “We know that persons who are racial and ethnic minorities have higher prevalence rates of chronic health conditions. These same groups are also disproportionately incarcerated. We know almost nothing about how and why incarceration affects age-related conditions. With nearly two million people incarcerated an average day in the U.S., it is an urgent, albeit seldom investigated, public health dilemma.”

Alzheimer's Disease and Related Dementias are a group of debilitating, progressive conditions that severely reduce a person’s memory, cognition, and ability to function independently. It’s estimated that 6.7 million Americans are living with ADRD, a number that’s expected to reach 13.8 million by 2060. There is no cure for ADRD, which makes prevention the only viable treatment.

While certain health factors such as hypertension and diabetes are known to increase a person’s risk of developing ADRD, little is known about how incarceration influences their vulnerability. Teplin’s study aims to uncover exactly how incarceration impacts cognitive health later in life, zeroing in on what she calls, “the dose of incarceration:” granular variables such as frequency and duration of incarceration, type of facility, age, and time since release.

People who have been incarcerated often struggle with economic stability, education, and healthcare access — key social determinants of health. By understanding the full experience of a person’s incarceration and subsequent re-entry, Teplin is confident that policymakers can develop more robust preventive interventions to improve health and reduce risk factors for ADRD.

The team at Northwestern is uniquely positioned to address the issue. In 1995, Teplin launched the Northwestern Juvenile Project (NJP), the first-ever longitudinal study investigating the mental health and long-term outcomes of youth detained in the juvenile justice system. Over the past 28 years, she and her team have remained in contact with the same group of 1,829 people, tracking outcomes such as psychiatric disorders, substance misuse, HIV/AIDS risk behaviors, and firearm injury as they aged. Those same participants, now in their 40s, will be the primary focus of the new health study, offering unparalleled insight into the health determinants of formerly incarcerated people from adolescence to mid-adulthood.   

Teplin’s work has already been instrumental in understanding incarcerated populations. Findings from the NJP program have been cited in reports by the U.S. Surgeon General, presented to the Supreme Court, used in congressional hearings, and widely disseminated by federal agencies and advocacy groups.

Teplin and her team are hopeful that the new study will provide the empirical foundation needed to reduce disparities in healthy aging and mitigate the risk for ADRD in people who have been incarcerated.

“We can’t ameliorate the consequences of incarceration until we know which aspects are the most detrimental for health,” said Teplin, who is also a member of the Buehler Center for Health Policy and Economics. “With over 95% of incarcerated persons eventually returning to their communities, we anticipate that millions of people may benefit from our findings. I am honored to conduct a study that will guide community health providers and correctional facilities to shape evidence-based interventions designed to meet the needs of this historically underserved population."

Other Northwestern collaborators on the project include Karen Abram, PhD; Kenzie A Cameron, PhD, MPH; Tamar Gefen, PhD; Kiarri N Kershaw, PhD; Christopher Kuzawa, PhD; Thomas W McDade, PhD; Sandra Weintraub, PhD and Leah J Welty, PhD.

This research is supported by the National Institute on Aging of the National Institutes of Health under project number 1R01AG089544-01. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.