Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.
Department of Pathology, Rush University Medical Center, Chicago, IL, USA.
J Alzheimers Dis. 2021;84(3):973-981. doi: 10.3233/JAD-201436.
Self-reported discrimination is a source of psychosocial stress that has been previously associated with poor cognitive function in older African Americans without dementia.
Here, we examine the association of discrimination with dementia and cognitive impairment in racially diverse older Brazilians.
We included 899 participants 65 years or older (34.3% Black) from the Pathology, Alzheimer's and Related Dementias Study (PARDoS), a community-based study of aging and dementia. A structured interview with informants of the deceased was conducted. The interview included the Clinical Dementia Rating (CDR) Scale for the diagnosis of dementia and cognitive impairment proximate to death and the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) as a second measure of cognitive impairment. Informant-reported discrimination was assessed using modified items from the Major and Everyday Discrimination Scales.
Discrimination was reported by informants of 182 (20.2%) decedents and was more likely reported by informants of Blacks than Whites (25.3% versus 17.6%, p = 0.006). Using the CDR, a higher level of informant-reported discrimination was associated with higher odds of dementia (OR: 1.24, 95% CI 1.08 -1.42, p = 0.002) and cognitive impairment (OR: 1.21, 95% CI: 1.06 -1.39, p = 0.004). Similar results were observed using the IQCODE (estimate: 0.07, SE: 0.02, p = 0.003). The effects were independent of race, sex, education, socioeconomic status, major depression, neuroticism, or comorbidities.
Higher level of informant-reported discrimination was associated with higher odds of dementia and cognitive impairment in racially diverse older Brazilians.
自我报告的歧视是一种社会心理压力源，先前与没有痴呆的非裔美国老年人认知功能较差有关。
在此，我们研究了在种族多样化的老年巴西人群中，歧视与痴呆和认知障碍的关系。
我们纳入了病理学、阿尔茨海默病及相关痴呆症研究（PARDoS）中的 899 名年龄在 65 岁或以上的参与者（34.3%为黑人），该研究是一项关于衰老和痴呆症的社区基础研究。对死者的知情人进行了结构化访谈。访谈包括使用临床痴呆评定量表（CDR）对痴呆症和接近死亡时的认知障碍进行诊断，以及使用认知下降知情者问卷（IQCODE）作为认知障碍的第二衡量标准。使用来自主要和日常歧视量表的改良项目评估知情人报告的歧视情况。
182 名（20.2%）死者的知情人报告了歧视，且黑人知情人比白人知情人更有可能报告歧视（25.3%比 17.6%，p=0.006）。使用 CDR，更高水平的知情人报告的歧视与痴呆症（OR：1.24，95%CI 1.08-1.42，p=0.002）和认知障碍（OR：1.21，95%CI：1.06-1.39，p=0.004）的可能性更高相关。使用 IQCODE 也观察到类似的结果（估计值：0.07，SE：0.02，p=0.003）。这些效果独立于种族、性别、教育、社会经济地位、重度抑郁症、神经质或合并症。
更高水平的知情人报告的歧视与种族多样化的老年巴西人群中痴呆症和认知障碍的可能性更高相关。
