National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA.
Department of Neurology, Vagelos College of Physicians & Surgeons, Columbia University, New York, NY, USA.
J Alzheimers Dis. 2021;80(3):1129-1138. doi: 10.3233/JAD-201370.
Variability 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.
Estimate 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.
Cases 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).
There 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.
In 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.
不同种族和族裔群体的痴呆症发病率差异估计为 60%。研究表明加勒比西班牙裔和非裔人群存在差异，但基于社区的研究数据有限。
估计种族和族裔多样化的社区为基础的北曼哈顿研究队列中轻度认知障碍（MCI）和痴呆症的患病率，并检查社会人口统计学、血管风险因素和脑影像学相关性。
MCI 和痴呆症的病例由一组神经心理学家和神经科医生进行裁决，并按种族/族裔群体估计患病率。使用有序比例优势模型估计 MCI 或痴呆症的患病率在种族/族裔之间的差异，调整社会人口统计学变量（模型 1）、模型 1 加潜在可改变的血管风险因素（模型 2）和模型 1 加脑完整性的结构影像学标志物（模型 3）。
有 989 名参与者有认知结果测定（平均年龄 69±9 岁；68%西班牙裔，16%非裔，14%白人；62%女性；平均（±标准差）随访时间为 5（±0.6）年）。与白人参与者相比，西班牙裔和非裔参与者更有可能患有 MCI（20%）和痴呆症（5%），尽管考虑了年龄和教育差异。在调整社会人口统计学变量、血管风险因素和脑影像学因素后，西班牙裔参与者患 MCI 或痴呆症的可能性高于白人和黑人参与者。白质高信号负荷与 MCI 或痴呆症的可能性增加显著相关（OR=1.3，1.1 至 1.6），但种族/族裔之间没有显著的相互作用。
在这个多样化的社区为基础的队列中，横断面数据显示 MCI 和痴呆症的患病率存在显著的种族/族裔差异。需要进行更长时间的随访和发病数据，以进一步阐明这些关系。
