Kindratt Tiffany B, Zahodne Laura B, Ajrouch Kristine J, Dallo Florence J
Public Health Program, Department of Kinesiology, University of Texas at Arlington, Arlington, Texas, USA.
Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA.
Innov Aging. 2024 Feb 29;8(3):igae025. doi: 10.1093/geroni/igae025. eCollection 2024.
Modifiable risk factors across the life course play a role in the development of Alzheimer's disease and related dementias (ADRD). Studies have identified racial and ethnic disparities in ADRD risk factors. Few studies have explored the epidemiology of ADRD risk among Middle Eastern and North African (MENA) Americans, largely due to their classification as White in US national health surveys. Our aim was to estimate ADRD risk factors among MENA immigrants compared to US- and foreign-born non-Hispanic White adults.
We linked cross-sectional 2000-2017 National Health Interview Survey and 2001-2018 Medical Expenditure Panel Survey data ( = 108 695; age ≥ 18 years). Modifiable risk factors for ADRD that were evaluated (yes or no) included less than ninth grade education, hearing loss, traumatic brain injury, hypertension, alcohol use, obesity, smoking, depressive symptoms, marital status, physical inactivity, and diabetes. Bivariate analysis and multivariable logistic regression were conducted. Regression models were adjusted by age and sex.
Compared to US-born White adults, MENA immigrants had higher odds of reporting less than 9th grade education (OR = 1.93; 95% CI = 1.17-3.21) and psychological health concerns (OR = 1.28; 95% CI = 1.06-1.56). Compared to foreign-born White adults, MENA immigrants had higher odds of diabetes (OR = 1.48; 95% CI = 1.06-2.08) and psychological health concerns (OR = 1.24; 95% CI = 1.01-1.54).
The findings provide the first comprehensive look at potentially modifiable risk factors for ADRD among MENA immigrants based on a life course model. Without a racial/ethnic identifier for MENA individuals on a national level, ADRD risk factors among US-born MENA adults and MENA immigrants cannot be examined. More research is needed to explore these risk factors by life stage (early, midlife, and late) to further determine ADRD risk and prevention strategies for MENA Americans.
一生中可改变的风险因素在阿尔茨海默病及相关痴呆症（ADRD）的发展过程中起作用。研究已确定ADRD风险因素存在种族和民族差异。很少有研究探讨中东和北非（MENA）裔美国人中ADRD风险的流行病学情况，主要是因为在美国国家健康调查中他们被归类为白人。我们的目的是估计与美国出生和外国出生的非西班牙裔白人成年人相比，MENA移民中的ADRD风险因素。
我们将2000 - 2017年国家健康访谈调查的横断面数据与2001 - 2018年医疗支出面板调查数据相链接（n = 108695；年龄≥18岁）。评估的ADRD可改变风险因素（是或否）包括九年级以下教育程度、听力损失、创伤性脑损伤、高血压、饮酒、肥胖、吸烟、抑郁症状、婚姻状况、身体活动不足和糖尿病。进行了双变量分析和多变量逻辑回归。回归模型按年龄和性别进行了调整。
与美国出生的白人成年人相比，MENA移民报告九年级以下教育程度的几率更高（OR = 1.93；95%CI = 1.17 - 3.21），心理健康问题的几率也更高（OR = 1.28；95%CI = 1.06 - 1.56）。与外国出生的白人成年人相比，MENA移民患糖尿病的几率更高（OR = 1.48；95%CI = 1.06 - 2.08），心理健康问题的几率也更高（OR = 1.24；95%CI = 1.01 - 1.54）。
这些发现基于生命历程模型首次全面审视了MENA移民中ADRD潜在的可改变风险因素。由于国家层面没有针对MENA个体的种族/民族标识符，无法研究美国出生的MENA成年人和MENA移民中的ADRD风险因素。需要更多研究按生命阶段（早期、中年和晚期）探索这些风险因素，以进一步确定MENA裔美国人的ADRD风险和预防策略。
