Breton Jordana, Foret Janelle T, Hamlin Abbey M, Ortega Nazareth, Clark Alexandra L
Department of Psychology, The University of Texas at Austin, Austin, TX, USA.
Clin Neuropsychol. 2025 May;39(4):915-930. doi: 10.1080/13854046.2024.2392303. Epub 2024 Aug 19.
Latino adults are at increased risk of metabolic syndrome (MetS) and have lower rates of health insurance (HI) coverage. Although inadequate HI coverage and MetS have been independently linked to poor cognition, their potential interactive effects have not yet been examined. The present study explored whether HI moderated the association between MetS and cognition. We hypothesized that Latinos with MetS that did not have HI would demonstrate poorer cognition than those with HI, whereas there would be minimal differences in cognition across HI status in those without MetS. Cross-sectional data from 805 Latino older adults enrolled in the Health and Aging Brain Study-Health Disparities was utilized. Analysis of covariance adjusting for sociodemographics examined MetS x HI interactions on memory and attention/executive functions composites. Results revealed a significant MetS x HI interaction on memory ( = 4.33, = 0.037, η = .01); Latino adults with MetS and no HI coverage had worse memory performance than those with MetS who had HI coverage ( = 0.022, η = .01), whereas there was no significant difference in memory between HI coverage groups in those without MetS ( > .05, η = .002). No MetS x HI interaction was observed for the attention/executive functions composite ( = 0.29, = 0.588, η < .001). Latino older adults with MetS that do not have HI coverage may be at risk for poorer memory outcomes. Increasing the accessibility of HI coverage may help reduce cognitive health disparities in Latino older adults with vascular health comorbidities.
拉丁裔成年人患代谢综合征(MetS)的风险增加,且医疗保险(HI)覆盖比例较低。尽管医疗保险覆盖不足和代谢综合征都与认知能力差独立相关,但其潜在的交互作用尚未得到研究。本研究探讨了医疗保险是否调节了代谢综合征与认知之间的关联。我们假设,患有代谢综合征但没有医疗保险的拉丁裔人群,其认知能力会比有医疗保险的人群更差,而在没有代谢综合征的人群中,不同医疗保险状况下的认知能力差异极小。我们使用了来自参与“健康与衰老大脑研究——健康差异”的805名拉丁裔老年人的横断面数据。通过协方差分析对社会人口统计学因素进行调整,研究了代谢综合征与医疗保险在记忆和注意力/执行功能综合指标上的交互作用。结果显示,在记忆方面存在显著的代谢综合征与医疗保险交互作用(F = 4.33,p = 0.037,η² = 0.01);患有代谢综合征且没有医疗保险覆盖的拉丁裔成年人,其记忆表现比有医疗保险覆盖的代谢综合征患者更差(p = 0.022,η² = 0.01),而在没有代谢综合征的人群中,不同医疗保险覆盖组之间的记忆能力没有显著差异(p > 0.05,η² = 0.002)。在注意力/执行功能综合指标上未观察到代谢综合征与医疗保险的交互作用(F = 0.29,p = 0.588,η² < 0.001)。没有医疗保险覆盖的患有代谢综合征的拉丁裔老年人可能面临较差记忆结果的风险。提高医疗保险覆盖的可及性可能有助于减少患有血管健康合并症的拉丁裔老年人的认知健康差距。