Charting psychosocial risk and resilience for cognitive decline: Launching the 25-year Follow-up of the National Survey of American Life

Former US Surgeon General David Satcher called Alzheimer’s disease “the most under-recognized threat to public health in the 21st century.” Part of this urgency stems from the challenge of conducting well-characterized longitudinal studies that follow individuals for decades in order to characterize the wide array of potentially-modifiable factors that are thought to contribute to cognitive decline in later life. This data gap is particularly stark for Black Americans, who remain significantly under-represented in research on dementia despite having earlier onset and higher incidence of this condition.

In 2001, researchers at the University of Michigan launched the National Survey of American Life (NSAL), the first nationally-representative health survey of Black Americans ever conducted. The goals of the NSAL were to examine how psychosocial factors like stress, coping, early-life experiences, and cultural beliefs relate to mental health and psychiatric disorders within the Black population. Twenty-five years later, the NSAL remains unparalleled in terms of its characterization of heterogeneity in psychological, social, behavioral, and environmental factors within the Black population.

In 2026, we are seeking to reinterview this singular cohort to chart the pathways of risk and resilience between psychosocial factors and dementia. We are launching this follow-up in Michigan, where it began 25 years ago, with the help of creative and collaborative partnerships across the state. In this talk, I will summarize the methodological innovations of the original NSAL and describe the new innovations we are applying in this follow-up effort, as well as key scientific questions we aim to address with this study. Overall, this talk will illustrate how interdisciplinary collaboration and team science are essential components in the effort to address critical gaps in our understanding of the drivers of cognitive aging and decline for all Americans.