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Risk of mild cognitive impairment among older adults in the United States by ethnoracial group

Published online by Cambridge University Press:  17 January 2020

Jaime Perales-Puchalt Open the ORCID record for Jaime Perales-Puchalt [Opens in a new window] ,
Kathryn Gauthreaux ,
Ashley Shaw ,
Jerrihlyn L. McGee ,
Merilee A. Teylan ,
Kwun C. G. Chan ,
Katya Rascovsky ,
Walter A. Kukull  and
Eric D. Vidoni
Jaime Perales-Puchalt*
Affiliation:
Alzheimer’s Disease Center, University of Kansas, MS6002, Fairway, KS66205, USA
Kathryn Gauthreaux
Affiliation:
Department of Epidemiology, National Alzheimer’s Coordinating Center, University of Washington, Seattle, WA98195, USA
Ashley Shaw
Affiliation:
Alzheimer’s Disease Center, University of Kansas, MS6002, Fairway, KS66205, USA
Jerrihlyn L. McGee
Affiliation:
School of Nursing, University of Kansas, MS 4043, Kansas City, KS66160, USA
Merilee A. Teylan
Affiliation:
Department of Epidemiology, National Alzheimer’s Coordinating Center, University of Washington, Seattle, WA98195, USA
Kwun C. G. Chan
Affiliation:
Department of Biostatistics, National Alzheimer’s Coordinating Center, University of Washington, Seattle, WA98195, USA
Katya Rascovsky
Affiliation:
Department of Neurology, Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
Walter A. Kukull
Affiliation:
Department of Epidemiology, National Alzheimer’s Coordinating Center, University of Washington, Seattle, WA98195, USA
Eric D. Vidoni
Affiliation:
Alzheimer’s Disease Center, University of Kansas, MS6002, Fairway, KS66205, USA
*
Correspondence should be addressed to: Jaime Perales-Puchalt, Alzheimer’s Disease Center, University of Kansas, MS6002, Fairway, KS66205, USA. Phone: +913 588 3716. E-mail: [email protected].
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Abstract

Objectives:

To compare the risk of mild cognitive impairment (MCI) among a wide range of ethnoracial groups in the US.

Design:

Non-probabilistic longitudinal clinical research.

Setting:

Participants enrolling into the National Alzheimer’s Coordinating Center Unified Data Set recruited via multiple approaches including clinician referral, self-referral by patients or family members, or active recruitment through community organizations.

Participants:

Cognitively normal individuals 55 and older at the initial visit, who reported race and ethnicity information, with at least two visits between September 2005 and November 2018.

Measurements:

Ethnoracial information was self-reported and grouped into non-Latino Whites, Asian Americans, Native Americans, African Americans (AAs), and individuals simultaneously identifying as AAs and another minority race (AA+), as well as Latinos of Caribbean, Mexican, and Central/South American origin. MCI was evaluated clinically following standard criteria. Four competing risk analysis models were used to calculate MCI risk adjusting for risk of death, including an unadjusted model, and models adjusting for non-modifiable and modifiable risk factors.

Results:

After controlling for sex and age at initial visit, subhazard ratios of MCI were statistically higher than non-Latino Whites among Native Americans (1.73), Caribbean Latinos (1.80), and Central/South American Latinos (1.55). Subhazard ratios were higher among AA+ compared to non-Latino Whites only in the model controlling for all risk factors (1.40).

Conclusion:

Compared to non-Latino Whites, MCI risk was higher among Caribbean and South/Central American Latinos as well as Native Americans and AA+. The factors explaining the differential MCI risk among ethnoracial groups are not clear and warrant future research.

Keywords

mild cognitive impairmentraceethnicityhealth disparities
Type
Original Research Article
Information
International Psychogeriatrics , Volume 33 , Special Issue 1: Issue Theme: Assessment of Risk Markers for Cognitive Impairment , January 2021 , pp. 51 - 62
Copyright
© International Psychogeriatric Association 2020

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References

Allison, P. D. (2010). Survival Analysis using SAS: A Practical Guide. Cary, NC: SAS Institute.Google Scholar
Alzheimer’s Association. (2017). 2017 Alzheimer’s disease facts and figures. Alzheimer’s & Dementia, 13, 325–373.10.1016/j.jalz.2017.02.001CrossRefGoogle Scholar
American Psychiatric Association. (2000). Diagnostic and Statistical Manual-text Revision (DSM-IV-TRim, 2000). Washington, DC: American Psychiatric Association.Google Scholar
Arellano-Morales, L. et al. (2015). Prevalence and correlates of perceived ethnic discrimination in the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study. Journal of Latina/o psychology, 3, 160.CrossRefGoogle ScholarPubMed
Barnes, L. L. and Bennett, D. A. (2014). Alzheimer’s disease in African Americans: risk factors and challenges for the future. Health affairs, 33, 580–586.10.1377/hlthaff.2013.1353CrossRefGoogle ScholarPubMed
Besser, L. et al. (2018). Version 3 of the National Alzheimer’s coordinating center’s uniform data set. Alzheimer Disease and Associated Disorders, 32, 351.CrossRefGoogle ScholarPubMed
Borenstein, A. R. et al. (2014). Incidence rates of dementia, Alzheimer’s disease and vascular dementia in the Japanese American Population in Seattle, WA: The Kame Project. Alzheimer Disease and Associated Disorders, 28, 23.10.1097/WAD.0b013e3182a2e32fCrossRefGoogle ScholarPubMed
Chavez-Dueñas, N. Y., Adames, H. Y., Perez-Chavez, J. G. and Salas, S. P. (2019). Healing ethno-racial trauma in Latinx immigrant communities: cultivating hope, resistance, and action. American Psychologist, 74, 49.CrossRefGoogle ScholarPubMed
Chen, C. and Zissimopoulos, J. M. (2018). Racial and ethnic differences in trends in dementia prevalence and risk factors in the United States. Alzheimer’s & Dementia: Translational Research & Clinical Interventions, 4, 510–520.Google ScholarPubMed
Conomos, M. P. et al. (2016). Genetic diversity and association studies in US Hispanic/Latino populations: applications in the Hispanic Community Health Study/Study of Latinos. The American Journal of Human Genetics, 98, 165–184.CrossRefGoogle ScholarPubMed
Crane, P. K. et al. (2009). Midlife use of written Japanese and protection from late life dementia. Epidemiology, 20, 766.CrossRefGoogle ScholarPubMed
Du, Y., Shih, M., Lightstone, A. S. and Baldwin, S. (2017). Hypertension among Asians in Los Angeles County: findings from a multiyear survey. Preventive Medicine Reports, 6, 302–306.CrossRefGoogle ScholarPubMed
Duara, R. et al. (1996). Alzheimer’s disease: interaction of apolipoprotein E genotype, family history of dementia, gender, education, ethnicity, and age of onset. Neurology, 46, 1575–1579.CrossRefGoogle ScholarPubMed
Ennis, S. R., Ríos-Vargas, M. and Albert, N. G. (2011). The Hispanic Population: 2010. Washington, DC: US Department of Commerce, Economics and Statistics Administration.Google Scholar
Evans, D. A. et al. (2003). Incidence of Alzheimer disease in a biracial urban community: relation to apolipoprotein E allele status. Archives of Neurology, 60, 185–189.CrossRefGoogle Scholar
Fillenbaum, G. G. et al. (1998). The prevalence and 3-year incidence of dementia in older black and white community residents. Journal of Clinical Epidemiology, 51, 587–595.CrossRefGoogle ScholarPubMed
Fine, J. P. and Gray, R. J. (1999). A proportional hazards model for the subdistribution of a competing risk. Journal of the American Statistical Association, 94, 496–509.CrossRefGoogle Scholar
Foley, D. et al. (2001). Daytime sleepiness is associated with 3‐year incident dementia and cognitive decline in older Japanese‐American men. Journal of the American Geriatrics Society, 49, 1628–1632.10.1111/j.1532-5415.2001.49271.xCrossRefGoogle ScholarPubMed
Freitag, M. H. et al. (2006). Midlife pulse pressure and incidence of dementia: the Honolulu-Asia Aging Study. Stroke, 37, 33–37.CrossRefGoogle ScholarPubMed
Gallagher-Thompson, D., Solano, N., Coon, D. and Arean, P. (2003). Recruitment and retention of Latino dementia family caregivers in intervention research: issues to face, lessons to learn. The Gerontologist, 43, 45–51.CrossRefGoogle Scholar
Gao, S. et al. (2011). Accelerated weight loss and incident dementia in an elderly African‐American cohort. Journal of the American Geriatrics Society, 59, 18–25.CrossRefGoogle Scholar
Glymour, M. M. and Manly, J. J. (2008). Lifecourse social conditions and racial and ethnic patterns of cognitive aging. Neuropsychology Review, 18, 223–254.CrossRefGoogle ScholarPubMed
González, H. M. et al. (2014). Neurocognitive function among middle-aged and older Hispanic/Latinos: results from the Hispanic Community Health Study/Study of Latinos. Archives of Clinical Neuropsychology, 30, 68–77.CrossRefGoogle ScholarPubMed
González-Barrera, A. (2019). Hispanics with Darker Skin Are More Likely to Experience Discrimination Than Those with Lighter Skin. Washington, DC: Pew Research Center.Google Scholar
Gurland, B. J. et al. (1999). Rates of dementia in three ethnoracial groups. International Journal of Geriatric Psychiatry, 14, 481–493.3.0.CO;2-5>CrossRefGoogle ScholarPubMed
Haan, M. N., Mungas, D. M., Gonzalez, H. M., Ortiz, T. A., Acharya, A. and Jagust, W. J. (2003). Prevalence of dementia in older Latinos: the influence of type 2 diabetes mellitus, stroke and genetic factors. Journal of the American Geriatrics Society, 51, 169–177.CrossRefGoogle ScholarPubMed
Havlik, R. J. et al. (2000). APOE-ϵ4 predicts incident AD in Japanese-American men: the Honolulu–Asia aging study. Neurology, 54, 1526–1529.CrossRefGoogle Scholar
Hendrie, H. C. et al. (1993). Alzheimer’s disease is rare in Cree. International Psychogeriatrics, 5, 5–14.CrossRefGoogle ScholarPubMed
Hendrie, H. C. et al. (2014). APOE ϵ4 and the risk for Alzheimer disease and cognitive decline in African Americans and Yoruba. International Psychogeriatrics, 26, 977–985.CrossRefGoogle Scholar
Ho, A. K., Sidanius, J., Levin, D. T. and Banaji, M. R. (2011). Evidence for hypodescent and racial hierarchy in the categorization and perception of biracial individuals. Journal of Personality and Social Psychology, 100, 492.CrossRefGoogle ScholarPubMed
Humes, K. R., Jones, N. A. and Ramirez, R. R. (2011). Overview of race and Hispanic origin: 2010.Google Scholar
Katz, M. J. et al. (2012). Age and sex specific prevalence and incidence of mild cognitive impairment, dementia and Alzheimer’s dementia in blacks and whites: a report from the Einstein Aging Study. Alzheimer Disease and Associated Disorders, 26, 335.CrossRefGoogle ScholarPubMed
Letellier, N. et al. (2018). Sex-specific association between neighborhood characteristics and dementia: the Three-City cohort. Alzheimer’s & Dementia, 14, 473–482.CrossRefGoogle ScholarPubMed
Lines, L. M. and Wiener, J. M. (2014). Racial and Ethnic Disparities in Alzheimer’s Disease: A Literature Review. Washington, DC: US Department of Health and Human Services, Assistant Secretary for Planning and Evaluation, Office of Disability, Aging and Long-Term Care Policy.Google Scholar
Louis, E. D., Tang, M. X. and Schupf, N. (2010). Mild parkinsonian signs are associated with increased risk of dementia in a prospective, population-based study of elders. Movement Disorders, 25, 172–178.10.1002/mds.22943CrossRefGoogle Scholar
Luchsinger, J. A., Tang, M.-X., Stern, Y., Shea, S. and Mayeux, R. (2001). Diabetes mellitus and risk of Alzheimer’s disease and dementia with stroke in a multiethnic cohort. American Journal of Epidemiology, 154, 635–641.CrossRefGoogle Scholar
Manly, J. J., Tang, M. X., Schupf, N., Stern, Y., Vonsattel, J. P. G. and Mayeux, R. (2008). Frequency and course of mild cognitive impairment in a multiethnic community. Annals of Neurology: Official Journal of the American Neurological Association and the Child Neurology Society, 63, 494–506.CrossRefGoogle Scholar
Manly, J. J., Touradji, P., Tang, M.-X. and Stern, Y. (2003). Literacy and memory decline among ethnically diverse elders. Journal of Clinical and Experimental Neuropsychology, 25, 680–690.CrossRefGoogle ScholarPubMed
Markides, K. S. and Eschbach, K. (2005). Aging, migration, and mortality: current status of research on the Hispanic paradox. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 60, S68–S75.CrossRefGoogle ScholarPubMed
Mateos, R. (2018). Mild cognitive impairment: some steps forward. International Psychogeriatrics, 30, 1427–1429.10.1017/S1041610218001886CrossRefGoogle ScholarPubMed
Mayeda, E. R., Glymour, M. M., Quesenberry, C. P. and Whitmer, R. A. (2016). Inequalities in dementia incidence between six racial and ethnic groups over 14 years. Alzheimers Dement, 12, 216–224.CrossRefGoogle ScholarPubMed
Morris, J. C. (1997). Clinical dementia rating: a reliable and valid diagnostic and staging measure for dementia of the Alzheimer type. International Psychogeriatrics, 9, 173–176.CrossRefGoogle ScholarPubMed
Muller, M., Tang, M.-X., Schupf, N., Manly, J. J., Mayeux, R. and Luchsinger, J. A. (2007). Metabolic syndrome and dementia risk in a multiethnic elderly cohort. Dementia and Geriatric Cognitive Disorders, 24, 185–192.CrossRefGoogle Scholar
National Institute on Aging. (2018). Goal F: understand health disparities and develop strategies to improve the health status of older adults in diverse populations. Bethesda, MD.Google Scholar
Norton, S., Matthews, F. E., Barnes, D. E., Yaffe, K. and Brayne, C. (2014). Potential for primary prevention of Alzheimer’s disease: an analysis of population-based data. The Lancet Neurology, 13, 788–794.10.1016/S1474-4422(14)70136-XCrossRefGoogle ScholarPubMed
Ortman, J. M., Velkoff, V. A. and Hogan, H. (2014). An Aging Nation: The Older Population in the United States. Washington, DC: United States Census Bureau, Economics and Statistics Administration, US Department of Commerce.Google Scholar
Pase, M. P. et al. (2016). Association of ideal cardiovascular health with vascular brain injury and incident dementia. Stroke, 47, 1201–1206.10.1161/STROKEAHA.115.012608CrossRefGoogle ScholarPubMed
Pase, M. P., Satizabal, C. L. and Seshadri, S. (2017). Role of improved vascular health in the declining incidence of dementia. Stroke, 48, 2013–2020.10.1161/STROKEAHA.117.013369CrossRefGoogle ScholarPubMed
Perales‐Puchalt, J. et al. (2019). Cardiovascular health and dementia incidence among older adults in Latin America: results from the 10/66 Study. International Journal of Geriatric Psychiatry, 34, 1041–1049.CrossRefGoogle ScholarPubMed
Perkins, P., Annegers, J., Doody, R., Cooke, N., Aday, L. and Vernon, S. (1997). Incidence and prevalence of dementia in a multiethnic cohort of municipal retirees. Neurology, 49, 44–50.CrossRefGoogle Scholar
Petersen, R. C. and Morris, J. C. (2005). Mild cognitive impairment as a clinical entity and treatment target. Archives of Neurology, 62, 1160–1163.CrossRefGoogle ScholarPubMed
Pew Research Center. (2015). Multiracial in America: Proud, Diverse and Growing in Numbers (pp. 98–109). Washington, DC: Pew Research Center Social & Demographic Trends.Google Scholar
Ryan, C. L. and Bauman, K. (2016). Educational attainment in the United States: 2015. US Census Bureau. Population Characteristics Report (P20-578). Washington, DC.Google Scholar
Saczynski, J. S. et al. (2006). The effect of social engagement on incident dementia: the Honolulu-Asia Aging Study. American Journal of Epidemiology, 163, 433–440.CrossRefGoogle ScholarPubMed
Sanders, A. E. et al. (2010). Association of a functional polymorphism in the cholesteryl ester transfer protein (CETP) gene with memory decline and incidence of dementia. JAMA, 303, 150–158.CrossRefGoogle ScholarPubMed
Shadlen, M. F., Siscovick, D., Fitzpatrick, A. L., Dulberg, C., Kuller, L. H. and Jackson, S. (2006). Education, cognitive test scores, and black‐white differences in dementia risk. Journal of the American Geriatrics Society, 54, 898–905.CrossRefGoogle ScholarPubMed
Tang, M.-X. et al. (2001). Incidence of AD in African-Americans, Caribbean Hispanics, and Caucasians in northern Manhattan. Neurology, 56, 49–56.CrossRefGoogle ScholarPubMed
US Department of Health & Human Services. (2015). National plan to address Alzheimer’s Disease: 2015 update. https://aspe.hhs.gov/system/files/pdf/107031/NatlPlan2015%20with%20Note.pdf.Google Scholar
UCLA: Statistical Consulting Group. (2018). Introduction to survival analysis in SAS. https://stats.idre.ucla.edu/sas/seminars/sas-survival/.Google Scholar
Unger, R. K. (1979). Toward a redefinition of sex and gender. American Psychologist, 34, 1085.CrossRefGoogle Scholar
Wei, L. -J., Lin, D. Y. and Weissfeld, L. (1989). Regression analysis of multivariate incomplete failure time data by modeling marginal distributions. Journal of the American Statistical Association, 84, 1065–1073.CrossRefGoogle Scholar
Weintraub, S. et al. (2009). The Alzheimer’s Disease Centers’ Uniform Data Set (UDS): the neuropsychologic test battery. Alzheimer Disease and Associated Disorders, 23, 91–101.CrossRefGoogle ScholarPubMed
Wharton, W. et al. (2019). Interleukin 9 alterations linked to Alzheimer disease in African Americans. Annals of Neurology, 86, 407–418.CrossRefGoogle ScholarPubMed
Yaffe, K. et al. (2013). Effect of socioeconomic disparities on incidence of dementia among biracial older adults: prospective study. BMJ, 347, f7051.CrossRefGoogle ScholarPubMed
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