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INTRODUCTION: Neighborhood socioeconomic status (NSES) has been linked with overall health, and this study will evaluate whether NSES is cross-sectionally associated with cognition in non-Hispanic whites (NHWs) and Mexican Americans (MAs) from the Health and Aging Brain: Health Disparities Study (HABS-HD). METHODS: The HABS-HD is a longitudinal study conducted at the University of North Texas Health Science Center. The final sample analyzed (n = 1,312) were 50 years or older, with unimpaired cognition, and underwent an interview, neuropsychological examination, imaging, and blood draw. NSES was measured using the national area deprivation index (ADI) percentile ranking, which considered socioeconomic variables. Executive function and processing speed were assessed by the trail making tests (A and B) and the digit-symbol substitution test, respectively. Linear regression was used to assess the association of ADI and cognitive measures. RESULTS: MAs were younger, more likely to be female, less educated, had higher ADI scores, performed worse on trails B (all p < 0.05), and had lower prevalence of APOE4 + when compared to NHWs (p < 0.0001). A higher percentage of MAs lived in the most deprived neighborhoods than NHWs. For NHWs, ADI did not predict trails B or DSS scores, after adjusting for demographic variables and APOE4. For MAs, ADI predicted trails A, trails B, and DSS after adjusting for demographic covariates and APOE4 status. CONCLUSION: Our study revealed that living in an area of higher deprivation was associated with lower cognitive function in MAs but not in NHWs, which is important to consider in future interventions to slow cognitive decline.

Asunto(s)

Envejecimiento , Función Ejecutiva , Americanos Mexicanos , Pruebas Neuropsicológicas , Clase Social , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Envejecimiento/psicología , Cognición/fisiología , Estudios de Cohortes , Estudios Transversales , Disparidades en el Estado de Salud , Estudios Longitudinales , Americanos Mexicanos/psicología , Características del Vecindario , Velocidad de Procesamiento , Características de la Residencia , Texas/epidemiología , Blanco/psicología

RESUMEN

Objectives: This study aimed to compare the impact of cardiovascular disease (CVD) and cardiovascular risk factors (CVRF) on cognition in non-Hispanic Whites (NHW) versus Mexicans Americans (MA). Methods: A cross sectional analysis was conducted on 663 NHW and 632 MA. Prevalence of specific CVRF were compared between both demographics. Cognition was tested with various neuropsychologic tests. Results: MA had a higher percentage of hypertension, abdominal circumference, diabetes, and current smoking while NHW had a higher prevalence of other CVD. However, specific CVRF impacted NHW neuropsychologic testing on cognition, executive function, and processing, while only memory was affected in MA. Discussion: MA have less access to healthcare services with a higher prevalence of specific CVRF, however previous research has cited a lower mortality compared to NHW, this is known as the Hispanic paradox effect. The Mexican American ethnicity may be a protective factor in cognition creating increased neuropsychologic resilience from CVRF.

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Background: Subjective cognitive complaints (SCC) are associated with higher risk of mild cognitive impairment (MCI) and dementia. Cardiovascular risk factors (CVRF) have been also associated with cognitive decline, MCI, and dementia. Few studies have examined the associated of CVRF and SCC. Methods: Participants were cognitively normal Mexican Americans from the HABLE study. Participants were categorized as with and without SCC, and SCC was also measured as a continuous variable. CVRF diagnosis were ascertained during consensus review. Cognitive measures used were MMSE, Trails B, SEVLT, and digit span. Logistic regression and linear regression were used to asses the association of SCC with CVRF and cognitive scores. Results: A total of 673 participants [mean age 63.3 (SD=7.71), 69.2% female] were included. SCC was present in 323 participants (47.99%). Dyslipidemia and depression were associated with SCC. Individuals with dyslipidemia had 1.72 times the odds (95% CI = 1.20 to 2.47) of SCC, and those with depression had 3.15 times the odds (95% CI = 2.16 to 4.59) of self-reporting SCC. Higher SCC scores, were significantly associated with MMSE (B = 0.07; SE = 0.03; p = 0.02), and SEVLT immediate and delayed (B= -0.03; SE = 0.00; p = 0.000 and B = -0.03; SE = 0.00; p = 0.000, respectively). Conclusions: In a cognitively normal Mexican Americans sample of older adults, depression and dyslipidemia were correlated with self-reported SCC. A greater self-perception of cognitive decline correlated with lower scores on the MMSE and SEVLT.

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INTRODUCTION: Among vascular risk factors we hypothesized that an increased prevalence of diabetes in Hispanics would be associated with greater white matter hyperintensity (WMH) volume, which may contribute to cognitive decline. METHODS: A total of 1318 participants (60% female; 49% Hispanic, 51% non-Hispanic White; age 66.2 ± 8.9 years) underwent clinical evaluation and brain magnetic resonance imaging (MRI). WMH volume associations were assessed with age, sex, and ethnicity and then with vascular risk factors in a selective regression model. RESULTS: WMH volume was greater with older age (P < .0001), Hispanic ethnicity (P = .02), and female sex (P = .049). WMH volume was best predicted by age, diastolic blood pressure, hypertension history, hemoglobin A1c (HbA1c), white blood cell count, and hematocrit (P < .01 for all). Elevated HbA1c was associated with greater WMH volume among Hispanics (parameter estimate 0.08 ± 0.02, P < .0001) but not non-Hispanic Whites (parameter estimate 0.02 ± 0.04, P = .5). DISCUSSION: WMH volume was greater in Hispanics, which may be partly explained by increased WMH volume related to elevated HbA1c among Hispanics but not non-Hispanic Whites.

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BACKGROUND: The current project sought to evaluate the impact that white matter hyperintensities (WMH) have on executive function in cognitively normal Mexican Americans, an underserved population with onset and more rapid progression of dementia. METHODS: Data from 515 participants (360 female) enrolled in the Health and Aging Brain Study: Health Disparities project were analyzed. Participants underwent clinical evaluation, cognitive testing, and a brain MRI. Linear regression was used to predict the effect of total WMH volume on cognitive test scores. Age, sex, and education were entered as covariates. RESULTS: Regression analysis showed that WMH volume significantly predicted executive function. WMH also predicted global cognition and attention scores, although not significantly after adjusting for age. CONCLUSION: In this sample of cognitively normal Mexican Americans, we found that WMH volume was associated with lower scores in a measure of executive function, after accounting for age, sex, and education.

RESUMEN

INTRODUCTION: In the United States, information on the Mexican-American population is available through the Health and Aging Brain among Latino Elders (HABLE) study; in Mexico, the results of the Mexican Health and Aging Study (MHAS) are available. OBJECTIVE: To compare the prevalence of cardiovascular risk factors between men and women of the HABLE and MHAS studies. METHOD: The prevalence of hypertension, diabetes, hypercholesterolemia and abdominal obesity was transversely analyzed in 559 HABLE participants and compared with data from 13,663 MHAS participants. The comparison was made using Student's t-test and the chi-square test, according to the type of variable. RESULTS: The analysis showed that the prevalence of hypertension (50 %, 95 % CI = 41.8-51.8), diabetes (35.5 %, 95 % CI = 27.6-43.8) and abdominal obesity (59.3 %, 95 % CI = 50.5-68.1) were significantly higher in HABLE males, whereas females had a higher prevalence of diabetes (36.8 %, 95 % CI = 32.2-41.5) and abdominal obesity (89.6 %, 95 % CI = 86.6-92.5). Hypercholesterolemia had a higher prevalence in MHAS females (53.3%, 95% CI = 50.3-56.2). CONCLUSION: The prevalence of cardiovascular risk factors was higher in Mexican American HABLE participants, than in Mexican MHAS participants.

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INTRODUCCIÓN: En Estados Unidos se dispone de información acerca de la población mexicoamericana por el Estudio de Salud y Envejecimiento del Cerebro en Latinos Mayores (HABLE); en México se dispone de los resultados del Estudio Nacional de Salud y Envejecimiento en México (ENASEM). OBJETIVO: Comparar la prevalencia de factores de riesgo cardiovascular entre hombres y mujeres de HABLE y ENASEM. MÉTODO: Se analizó transversalmente la prevalencia de hipertensión, diabetes, hipercolesterolemia y obesidad abdominal en 559 participantes de HABLE y se comparó con datos de 13 663 participantes del ENASEM. La comparación se realizó mediante t de Student y chi cuadrada, según el tipo de variable. RESULTADOS: El análisis demostró que la prevalencia de hipertensión (50 %, IC 95 % = 41.8-51.8), diabetes (35.5 %, IC 95 % = 27.6-43.8) y obesidad abdominal (59.3 %, IC 95 % = 50.5-68.1) fueron significativamente mayores en hombres del HABLE, mientras que las mujeres presentaron una prevalencia más elevada de diabetes (36.8 %, IC 95 % = 32.2-41.5) y obesidad abdominal (89.6 %, IC 95 % = 86.6-92.5). La hipercolesterolemia tuvo una prevalencia más elevada en mujeres del ENASEM (53.3 %, IC 95 % = 50.3-56.2). CONCLUSIÓN: La prevalencia de factores de riesgo cardiovascular fue mayor en mexicoamericanos participantes del HABLE, que en mexicanos participantes del ENASEM.

Asunto(s)

Enfermedades Cardiovasculares/etiología , Diabetes Mellitus/epidemiología , Hipercolesterolemia/epidemiología , Hipertensión/epidemiología , Obesidad Abdominal/epidemiología , Anciano , Anciano de 80 o más Años , Enfermedades Cardiovasculares/etnología , Estudios Transversales , Diabetes Mellitus/etnología , Femenino , Encuestas Epidemiológicas/estadística & datos numéricos , Humanos , Hipercolesterolemia/etnología , Hipertensión/etnología , Estudios Longitudinales , Masculino , Americanos Mexicanos/estadística & datos numéricos , México/epidemiología , México/etnología , Persona de Mediana Edad , Obesidad Abdominal/etnología , Factores de Riesgo , Distribución por Sexo , Estados Unidos/epidemiología

RESUMEN

Resumen Introducción: En Estados Unidos se dispone de información acerca de la población mexicoamericana por el Estudio de Salud y Envejecimiento del Cerebro en Latinos Mayores (HABLE); en México se dispone de los resultados del Estudio Nacional de Salud y Envejecimiento en México (ENASEM). Objetivo: Comparar la prevalencia de factores de riesgo cardiovascular entre hombres y mujeres de HABLE y ENASEM. Método: Se analizó transversalmente la prevalencia de hipertensión, diabetes, hipercolesterolemia y obesidad abdominal en 559 participantes de HABLE y se comparó con datos de 13 663 participantes del ENASEM. La comparación se realizó mediante t de Student y chi cuadrada, según el tipo de variable. Resultados: El análisis demostró que la prevalencia de hipertensión (50 %, IC 95 % = 41.8-51.8), diabetes (35.5 %, IC 95 % = 27.6-43.8) y obesidad abdominal (59.3 %, IC 95 % = 50.5-68.1) fueron significativamente mayores en hombres del HABLE, mientras que las mujeres presentaron una prevalencia más elevada de diabetes (36.8 %, IC 95 % = 32.2-41.5) y obesidad abdominal (89.6 %, IC 95 % = 86.6-92.5). La hipercolesterolemia tuvo una prevalencia más elevada en mujeres del ENASEM (53.3 %, IC 95 % = 50.3-56.2). Conclusión: La prevalencia de factores de riesgo cardiovascular fue mayor en mexicoamericanos participantes del HABLE, que en mexicanos participantes del ENASEM.

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Abstract Introduction: In the United States, information on the Mexican-American population is available through the Health and Aging Brain among Latino Elders (HABLE) study; in Mexico, the results of the Mexican Health and Aging Study (MHAS) are available. Objective: To compare the prevalence of cardiovascular risk factors between men and women of the HABLE and MHAS studies. Method: The prevalence of hypertension, diabetes, hypercholesterolemia and abdominal obesity was transversely analyzed in 559 HABLE participants and compared with data from 13,663 MHAS participants. The comparison was made using Student’s t-test and the chi-square test, according to the type of variable. Results: The analysis showed that the prevalence of hypertension (50 %, 95 % CI = 41.8-51.8), diabetes (35.5 %, 95 % CI = 27.6-43.8) and abdominal obesity (59.3 %, 95 % CI = 50.5-68.1) were significantly higher in HABLE males, whereas females had a higher prevalence of diabetes (36.8 %, 95 % CI = 32.2-41.5) and abdominal obesity (89.6 %, 95 % CI = 86.6-92.5). Hypercholesterolemia had a higher prevalence in MHAS females (53.3%, 95% CI = 50.3-56.2). Conclusion: The prevalence of cardiovascular risk factors was higher in Mexican American HABLE participants, than in Mexican MHAS participants.

Asunto(s)

Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Enfermedades Cardiovasculares/etiología , Diabetes Mellitus/epidemiología , Obesidad Abdominal/epidemiología , Hipercolesterolemia/epidemiología , Hipertensión/epidemiología , Estados Unidos/epidemiología , Enfermedades Cardiovasculares/etnología , Estudios Transversales , Factores de Riesgo , Encuestas Epidemiológicas/estadística & datos numéricos , Estudios Longitudinales , Americanos Mexicanos/estadística & datos numéricos , Distribución por Sexo , Diabetes Mellitus/etnología , Obesidad Abdominal/etnología , Hipercolesterolemia/etnología , Hipertensión/etnología , México/etnología , México/epidemiología

RESUMEN

C-reactive protein (CRP) is a biomarker for cardiovascular events and also has been studied as a biomarker for cognitive decline. By the year 2050 the Hispanic population in the United States will reach 106 million, and 65% of those will be of Mexican heritage. The purpose of this study was to evaluate the association between CRP levels and cognitive functioning in a sample of Mexican American older adults. A cross-sectional analysis of data from 328 cognitive normal, Mexican American participants from the community-based Health and Aging Brain Among Latino Elders (HABLE) study were performed. Statistical methods included t-test, chi square, multiple linear regression, and logistic regression modeling. Cognitive performance was measured by the Mini Mental State Examination (MMSE), Logical Memory I and II, Digit Span, FAS, and Animal Naming tests. Age, years of education, gender, diagnostic of hypertension, diabetes, and dyslipidemia were entered in the model as covariates. High CRP levels significantly predicted FAS scores (B = -0.135, P = .01), even after adjusting for covariates. Education (B = 0.30, P < .05), and diagnosis of hypertension (B = -0.12, P = .02) were also independent predictors of FAS scores. Participants with higher CRP levels had greater adjusted odds of poorer performance in the FAS test (OR = 1.75, 95% CI = 1.13-2.72, P = .01) when compared to participants with lower CRP levels. This was also true for participants with hypertension (OR = 2.20, 95% CI = 1.34-3.60, P < .05). Higher CRP levels were not associated with MMSE, logical memory, digit span, and animal naming scores. In conclusion, our study showed a clear association between CRP levels and verbal fluency and executive function in a cognitively normal community-dwelling population of Mexican-Americans.

Asunto(s)

Proteína C-Reactiva/análisis , Cognición , Anciano , Anciano de 80 o más Años , Disfunción Cognitiva/sangre , Disfunción Cognitiva/diagnóstico , Disfunción Cognitiva/epidemiología , Estudios Transversales , Femenino , Humanos , Estudios Longitudinales , Masculino , Americanos Mexicanos , Persona de Mediana Edad , Pruebas Neuropsicológicas , Factores de Riesgo , Estados Unidos

RESUMEN

BACKGROUND: Recent evidence suggests that increasing dietary intake of minerals reduces the risk of dementia. This study aimed to examine the relationship between potassium and diagnosis of mild cognitive impairment (MCI) in a sample of older Mexican-Americans from rural and urban populations. METHODS: The sample was formed of a total of 139 participants with MCI and 371 normal controls from two independent cohorts: a rural cohort (Facing Rural Obstacles to Healthcare Now through Intervention, Education and Research [Project FRONTIER]) and an urban cohort (the Health and Aging Brain among Latino Elders [HABLE] study). Serum electrolytes examined were sodium and potassium. Age and education were entered in the model as covariates. RESULTS: Across both cohorts, the Project FRONTIER (OR = 3.1; p = 0.01) and the HABLE Project (OR = 2.0; p = 0.04), the results indicated that serum potassium levels significantly increased the risk of diagnosis of MCI. CONCLUSION: Our finding suggested a link between serum potassium levels and a diagnosis of MCI in Mexican-Americans. The results of this study support a previous research which has suggested that the risk factors for MCI may vary by ethnicity.

RESUMEN

BACKGROUND: Late life depression is a prodromal feature and a risk factor for Alzheimer's disease (AD) and mild cognitive impairment (MCI). We identified five items in the Geriatric Depression scale (DepE) that are important as a risk for MCI and AD: memory problems, feeling blue, crying, feeling worthless, and trouble concentrating. OBJECTIVE: Our goal was to examine the relationship between DepE and cognition in a cohort of Mexican Americans. METHODS: Data from 317 Mexican Americans from the HABLE study were analyzed. DepE scores were dichotomized into two groups: endorsement of 1 item or less, and endorsement of 2 or more items. Cognition was assessed via neuropsychological tests, and diagnosis was based on consensus review. We utilized linear regression to examine the association between DepE and cognitive performance, and logistic regression to examine the utility of DepE in predicting MCI. To examine the impact of DepE on memory over 12 months, we performed ANOVA analysis. RESULTS: Elevated DepE scores were associated with poorer performance on various measures of memory and cognition, but not executive or visual spatial skills. Over 12 months, we found a decline in immediate memory among women but not men. Those with high scores were 4 times more likely to have MCI. ANOVA of total scores revealed differences between groups on immediate memory (p < 0.05) in women, with no significant differences on delay recall in either gender. CONCLUSION: DepE can be utilized in Mexican Americans to identify those at risk of memory related cognitive decline.

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Disfunción Cognitiva/diagnóstico , Disfunción Cognitiva/etnología , Depresión/diagnóstico , Depresión/etnología , Americanos Mexicanos/psicología , Anciano , Anciano de 80 o más Años , Cognición , Envejecimiento Cognitivo , Endofenotipos , Función Ejecutiva , Femenino , Humanos , Estudios Longitudinales , Masculino , Memoria , Persona de Mediana Edad , Pruebas Neuropsicológicas , Escalas de Valoración Psiquiátrica , Factores Sexuales , Percepción Espacial , Percepción Visual

RESUMEN

OBJECTIVES: To analyze the association between chronic kidney disease (CKD) and mild cognitive impairment (MCI) in Mexican Americans and to determine whether there is a blood-based proteomic profile linking CKD to MCI. DESIGN: Retrospective analysis of cohort study. SETTING: Health and Aging Brain among Latino Elders study. PARTICIPANTS: Mexican Americans (N = 437, 105 men, 332 women). MEASUREMENTS: Data were analyzed to examine the link between estimated glomerular filtration rate (eGFR) and detailed neuropsychological functioning. Serum proteomic markers were also examined. RESULTS: Lower eGFR levels were associated with significantly poorer neuropsychological functioning across multiple domains. After adjusting for age, sex, education, and diabetes mellitus, participants with an eGFR less than 45 mL/min per 1.73 m(2) performed significantly worse than those with an eGFR from 45 to 59 mL/min per 1.73 m(2) or 60 mL/min per 1.73 m(2) and higher in processing speed (F = 14.1, P < .001), executive functioning (F = 4.5, P = .01), visuospatial skills (F = 4.8, P = .009), and global cognitive functioning (F = 6.2, P = .002). Participants with an eGFR less than 45 mL/min per 1.73 m(2) also performed significantly worse than those with an eGFR of 60 mL/min per 1.73 m(2) or greater on delayed memory (F = 3.8, P = .02). There was a trend toward lower eGFR levels being associated with greater risk of MCI (odds ratio (OR) = 2.4, 95% confidence interval (CI) = 0.91-6.1, P = .07), which was stronger for men (OR = 9.6, 95% CI = 1.3-74.3, P = .03). A serum proteomic profile consisting of Factor VII, interleukin-10, C-reactive protein, and fatty acid binding protein was 93% accurate in detecting CKD-related MCI. CONCLUSION: Lower eGFR was associated with significantly poorer neuropsychological functioning in Mexican Americans. A blood-based profile was generated that was highly accurate in detecting CKD-related MCI. A blood profile capable of predicting CKD-related cognitive impairment would be of benefit for the design of clinical interventions.

Asunto(s)

Disfunción Cognitiva/diagnóstico , Tasa de Filtración Glomerular , Americanos Mexicanos , Insuficiencia Renal Crónica/epidemiología , Anciano , Anciano de 80 o más Años , Biomarcadores/sangre , Proteína C-Reactiva/análisis , Disfunción Cognitiva/epidemiología , Estudios de Cohortes , Factor VII/análisis , Proteínas de Unión a Ácidos Grasos/sangre , Femenino , Humanos , Interleucina-10/sangre , Masculino , Persona de Mediana Edad , Pruebas Neuropsicológicas , Estudios Retrospectivos , Factores Sexuales , Estados Unidos/epidemiología

RESUMEN

BACKGROUND: The links between diabetes, depression, and Alzheimer's disease (AD) has been established, but they are still poorly understood. However, little research has examined the effect that comorbidity of depression and diabetes has on cognitive impairment in an ethnically diverse sample. OBJECTIVE: The purpose of this study was to investigate the relationship between comorbid diabetes and depression on cognitive dysfunction; and examine the relationship in an ethnically diverse population. METHODS AND RESULTS: Analyses of data from 2,436 participants (914 men and 1,522 women) of three separate cohorts: HABLE, FRONTIER, and TARCC. In the HABLE cohort, comorbidity (odds ratio [OR] = 3.008; 95% CI = 1.358-6.667), age (OR = 1.138; 95% CI = 1.093-1.185), and education (OR = 0.915; 95% CI = 0.852-0.982) increased the risk of mild cognitive impairment (MCI) diagnosis among elderly Mexican American. In the TARCC cohort, results showed an increase risk of MCI in both non-Hispanic whites (OR = 18.795; 95% CI = 2.229-158.485) and Mexican Americans (OR = 8.417; 95% CI = 2.967-23.878). Finally, results in the FRONTIER cohort showed that in elderly Mexican Americans, comorbidity (OR = 2.754; 95% CI = 1.084-6.995) and age (OR = 1.069; 95% CI = 1.023-1.118) significantly increased risk of MCI. In non-Hispanic whites, comorbidity did not significantly increase risk of MCI. CONCLUSIONS: Among elderly Mexican Americans, comorbid depression and diabetes significantly increased risk for MCI and AD across cohorts. Effects of comorbid diabetes and depression on MCI were inconclusive. Our results support the link between comorbid diabetes and depression and risk for cognitive decline among Mexican Americans. This finding is of critical importance as the Hispanic population is at higher risk of developing AD.

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Envejecimiento , Enfermedad de Alzheimer/etiología , Disfunción Cognitiva/etiología , Depresión/complicaciones , Depresión/epidemiología , Diabetes Mellitus/epidemiología , Adulto , Anciano , Anciano de 80 o más Años , Envejecimiento/etnología , Enfermedad de Alzheimer/etnología , Disfunción Cognitiva/etnología , Estudios de Cohortes , Comorbilidad , Depresión/etnología , Diabetes Mellitus/etnología , Femenino , Humanos , Modelos Logísticos , Masculino , Americanos Mexicanos/estadística & datos numéricos , Persona de Mediana Edad , Pruebas Neuropsicológicas , Escalas de Valoración Psiquiátrica , Factores de Riesgo , Población Blanca