학술논문

Race/Ethnic Disparities in Mild Cognitive Impairment and Dementia: The Northern Manhattan Study
Document Type
article
Source
Journal of Alzheimer's Disease. 80(3)
Subject
Biomedical and Clinical Sciences
Biological Psychology
Clinical Sciences
Neurosciences
Psychology
Alzheimer's Disease
Vascular Cognitive Impairment/Dementia
Aging
Acquired Cognitive Impairment
Prevention
Clinical Research
Neurodegenerative
Behavioral and Social Science
Alzheimer's Disease including Alzheimer's Disease Related Dementias (AD/ADRD)
Brain Disorders
Dementia
Neurological
Mental health
Aged
Aged
80 and over
Cognitive Dysfunction
Cohort Studies
Cross-Sectional Studies
Ethnicity
Female
Humans
Male
Middle Aged
New York City
Prevalence
African American
cohort studies
dementia
Hispanic American
mild cognitive impairment
Cognitive Sciences
Neurology & Neurosurgery
Clinical sciences
Biological psychology
Language
Abstract
BackgroundVariability in dementia rates across racial and ethnic groups has been estimated at 60%. Studies suggest disparities in Caribbean Hispanic and Black populations, but community-based data are limited.ObjectiveEstimate the prevalence of mild cognitive impairment (MCI) and dementia in the racially and ethnically diverse community-based Northern Manhattan Study cohort and examine sociodemographic, vascular risk factor, and brain imaging correlates.MethodsCases of MCI and dementia were adjudicated by a team of neuropsychologists and neurologists and prevalence was estimated across race/ethnic groups. Ordinal proportional odds models were used to estimate race/ethnic differences in the prevalence of MCI or dementia adjusting for sociodemographic variables (model 1), model 1 plus potentially modifiable vascular risk factors (model 2), and model 1 plus structural imaging markers of brain integrity (model 3).ResultsThere were 989 participants with cognitive outcome determinations (mean age 69±9 years; 68% Hispanic, 16% Black, 14% White; 62% women; mean (±SD) follow-up five (±0.6) years). Hispanic and Black participants had greater likelihood of MCI (20%) and dementia (5%) than White participants accounting for age and education differences. Hispanic participants had greater odds of MCI or dementia than both White and Black participants adjusting for sociodemographic variables, vascular risk factors, and brain imaging factors. White matter hyperintensity burden was significantly associated with greater odds of MCI or dementia (OR = 1.3, 1.1 to 1.6), but there was no significant interaction by race/ethnicity.ConclusionIn this diverse community-based cohort, cross-sectional data revealed significant race/ethnic disparities in the prevalence of MCI and dementia. Longer follow-up and incidence data are needed to further clarify these relationships.