Rodriguez Miriam J, Mendoza Lisandra, Garcia Patricia, Duarte Andres, Padron Dilianna, Marsiske Michael, Fiala Jacob, Gonzalez Joanna, Duara Ranjan
Albizu University-Miami Campus Doral Florida USA.
Indiana University-Bloomington Bloomington Indiana USA.
Alzheimers Dement (Amst). 2024 Aug 10;16(3):e12632. doi: 10.1002/dad2.12632. eCollection 2024 Jul-Sep.
Poorer baseline functioning is associated with long-term cognitive decline among Hispanic older adults, but little is known about associations of these factors with Alzheimer's disease (AD) neuroimaging biomarkers.
A total of 461 Hispanic and White non-Hispanic (NHW) older adults who are cognitively normal ( = 76), had impaired cognition without mild cognitive impairment (MCI) ( = 41), or carried a diagnosis of MCI ( = 253) or dementia ( = 91) completed neuropsychological and functional assessment, genetic testing, and brain magnetic resonance imaging (MRI). Structural equation modeling (SEM) was used to examine predictive associations between functional and cognitive measures of AD neuroimaging biomarkers.
MRI volumes significantly predicted functional limitations in both groups. Sex and amyloid load significantly predicted functional limitations among the Hispanic group only. Years of education and MRI regional volume were the strongest predictors of cognition among both groups.
Results indicate that functional performance is associated with early AD biomarkers among Hispanic older adults. Clinical implications are discussed.
The current study addresses health disparities in Alzheimer's disease (AD) and related dementia assessment among Hispanics by identifying measures sensitive to early AD biomarkers.Associations of functional measures with AD genetic and neuroimaging biomarkers revealed that similarities in these associations exist between Hispanic and White non-Hispanic individuals, but biological sex and amyloid load significantly predicted functional limitations among the Hispanic group only.These results have clinical implications for physicians who treat Hispanic AD patients and indicate that when compared to traditional diagnostic assessments, functional assessments may better aid in AD diagnostic precision among Hispanics.
在西班牙裔老年人中，较差的基线功能与长期认知衰退有关，但对于这些因素与阿尔茨海默病（AD）神经影像学生物标志物之间的关联知之甚少。
共有461名认知正常（n = 76）、认知受损但无轻度认知障碍（MCI）（n = 41）、被诊断为MCI（n = 253）或痴呆（n = 91）的西班牙裔和非西班牙裔白人（NHW）老年人完成了神经心理学和功能评估、基因检测以及脑磁共振成像（MRI）。采用结构方程模型（SEM）来检验AD神经影像学生物标志物的功能和认知测量之间的预测关联。
MRI体积在两组中均显著预测了功能受限情况。仅在西班牙裔组中，性别和淀粉样蛋白负荷显著预测了功能受限情况。受教育年限和MRI区域体积是两组中认知的最强预测因素。
结果表明，在西班牙裔老年人中，功能表现与早期AD生物标志物相关。讨论了其临床意义。
本研究通过确定对早期AD生物标志物敏感的测量方法，解决了西班牙裔人群在阿尔茨海默病（AD）及相关痴呆评估中的健康差异问题。功能测量与AD基因和神经影像学生物标志物之间的关联表明，西班牙裔和非西班牙裔白人个体在这些关联上存在相似之处，但仅在西班牙裔组中，生物性别和淀粉样蛋白负荷显著预测了功能受限情况。这些结果对治疗西班牙裔AD患者的医生具有临床意义，并表明与传统诊断评估相比，功能评估可能更有助于提高西班牙裔人群AD诊断的准确性。
