Ferdows Nasim B, Aranda María P
Department of Public Health and Health Sciences, Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts, USA.
School of Public Policy and Urban Affairs, College of Social Sciences and Humanities, Northeastern University, Boston, Massachusetts, USA.
Clin Gerontol. 2025 Jul 17:1-14. doi: 10.1080/07317115.2025.2534651.
This study investigates racial/ethnic disparities in dementia risk and protective factors using data from the Health and Retirement Study (HRS) and the Harmonized Cognitive Assessment Protocol (HCAP).
A retrospective analysis of 3,495 individuals aged 65+ from the 2016 HCAP linked to the HRS was conducted. Cognitive status was assessed using the Mini-Mental State Examination (MMSE) scores. Risk factors included midlife cardiovascular conditions, hearing loss, current smoking, depression, and physical inactivity. Protective factors were education and wealth. The Oaxaca-Blinder decomposition method was used to quantify the contribution of these factors in explaining racial/ethnic disparities in cognitive functioning.
Black participants had 2.883 times higher odds of developing dementia compared to Whites, while Hispanic participants had 1.230 times higher odds (not statistically significant). Mid- and late-life risk and protective factors explained 32% of the cognitive gap between Black and White participants, and 70% between Hispanic and White participants, leaving 68% and 30% unexplained, respectively.
Addressing disparities in education, wealth, cardiovascular risks, depression, and hearing loss can reduce cognitive dysfunction in older adults.
Clinicians should target modifiable risk factors like depression and physical inactivity, particularly in minority populations. Addressing socioeconomic disparities is also crucial for improving cognitive health.
本研究利用健康与退休研究（HRS）和统一认知评估协议（HCAP）的数据，调查痴呆症风险及保护因素方面的种族/民族差异。
对2016年HCAP中3495名65岁及以上且与HRS相关联的个体进行回顾性分析。使用简易精神状态检查表（MMSE）分数评估认知状态。风险因素包括中年心血管疾病、听力损失、当前吸烟、抑郁和身体活动不足。保护因素为教育和财富。采用瓦哈卡-布林德分解法来量化这些因素在解释认知功能方面种族/民族差异中的作用。
与白人相比，黑人参与者患痴呆症的几率高出2.883倍，而西班牙裔参与者的几率高出1.230倍（无统计学意义）。中年和晚年的风险及保护因素分别解释了黑人和白人参与者之间32%的认知差距，以及西班牙裔和白人参与者之间70%的认知差距，分别仍有68%和30%无法解释。
解决教育、财富、心血管风险、抑郁和听力损失方面的差异可减少老年人的认知功能障碍。
临床医生应针对抑郁和身体活动不足等可改变的风险因素，尤其是在少数族裔人群中。解决社会经济差异对于改善认知健康也至关重要。
