Four interconnected research domains examining how environmental adversity shapes brain health.
This domain examines how traumatic life events, chronic stress, stigma, and discrimination shape emotional, cognitive, and neurobiological outcomes across the lifespan, with a particular focus on late-life cognitive aging and dementia risk. We are interested in understanding not just whether adversity matters, but how it gets under the skin to alter brain structure and function.
A central construct in this line of work is allostatic load (i.e., cumulative wear and tear due to chronic stress) and how it mediates the relationship between stressful experiences and cognitive decline. Dr. Prieto's dissertation, for example, examined longitudinal associations between discriminatory experiences, allostatic load, and cognitive functioning in older adults.
We also study stigma as a form of chronic social adversity. Research on epilepsy stigma explores how internalized stigma, affiliate stigma (among care partners), and intersectional identities shape mental health, self-management behavior, and quality of life. This work draws on survey, ecological momentary assessment, and qualitative approaches.
Keywords: PTSD, Allostatic Load, Metabolic Syndrome, Discrimination, Stigma, Perceived Stress, ACEs
Cognitive aging and dementia risk are not distributed equally. They are shaped by where people live, work, and grow up. This domain investigates how socioeconomic, neighborhood, and sociocultural factors influence cognitive trajectories, Alzheimer's disease biomarker accumulation, and access to neuropsychological services across the lifespan.
Our research investigates how social determinants of health interact with biological risk factors such as amyloid burden and APOE genotype to shape cognitive outcomes. We focus in particular on cognitively normal older adults who may already be experiencing the earliest combined effects of social and biological risk.
We also examine neighborhood deprivation as a driver of neuropsychological disparities in clinical populations. In addition, we study how structural factors including poverty, residential segregation, and limited access to healthcare contribute to inequities in cognitive care.
Keywords: SDOH, Neighborhood Disadvantage, Health Equity
Traditional neuropsychological assessment is resource-intensive, clinic-dependent, and often inaccessible for communities with limited transportation, time, or proximity to specialized care. This domain focuses on developing and validating scalable, remote, and technology-based tools that can extend the reach of cognitive assessment, particularly to underserved populations.
We are particularly interested in ecological momentary assessment (EMA) and smartphone-based paradigms that can capture cognitive performance, daily stress, and social context in real-world environments. This approach allows us to examine within-person variability (which is often obscured by single-time-point clinic-based assessments), and to understand how daily adversity exposures shape day-to-day cognitive functioning.
Keywords: Mobile Assessment, EMA, Remote Monitoring, Online Intervention, Within-Person Variability
Neuropsychology has significant work to do in the domains of equity, representation, and access. This fourth area of scholarship focuses on identifying and addressing structural barriers within the field itself, in training, research practices, clinical service delivery, and professional culture.
Dr. Prieto's advocacy scholarship includes systematic reviews of representation of women in neuropsychology research, qualitative analyses of the field's priorities and blind spots (as identified by experts), and work on improving parental leave and family-friendly policies in postdoctoral training programs.
This domain also encompasses science communication to ensure that findings from research on adversity, cognitive aging, and brain health reach community members, clinicians, educators, and policymakers in forms they can actually use.
Keywords: Representation, Gender Equity, Training, Science Communication, Policy
This project investigates how social, economic, and environmental factors shape older adults' perceptions of, access to, and engagement with cognitive screening and neuropsychological services. The goal is to identify modifiable barriers and develop strategies to improve equitable access to brain health care, particularly among individuals facing adversity, resource limitations, or historical mistrust of healthcare systems.
Keywords: SDOH, Older Adults, Healthcare Access, Cognitive Screening, Alzheimer's Disease
This project examines how social determinants of health and life-course adversity contribute to the accumulation of Alzheimer's disease and related dementia (AD/ADRD) biomarkers and influence cognitive aging. The goal is to determine whether social risk factors accelerate disease-related pathology and exacerbate the impact of biomarker burden on cognitive outcomes.
Keywords: Alzheimer's Disease, Biomarkers, SDOH, Cognitive Trajectories