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Risk factors for mild cognitive impairment among Mexican Americans.

ABSTRACT: Although a great deal of literature has focused on risk factors for mild cognitive impairment (MCI), little published work examines risk for MCI among Mexican Americans.Data from 1628 participants (non-Hispanic n = 1002; Mexican American n = 626) were analyzed from two ongoing studies of cognitive aging and Alzheimer's disease, Project FRONTIER (Facing Rural Obstacles to health Now Through Intervention, Education & Research) and TARCC (Texas Alzheimer's Research & Care Consortium).When looking at the full cohorts (non-Hispanic and Mexican American), age, education, Apolipoprotein E (APOE) ?4 status and gender were consistently related to MCI diagnosis across the two cohorts. However, when split by ethnicity, advancing age was the only significant risk factor for MCI among Mexican Americans across both cohorts.The current data suggest that many of the previously established risk factors for MCI among non-Hispanic cohorts may not be predictive of MCI among Mexican Americans and point to the need for additional work aimed at understanding factors related to cognitive aging among this underserved segment of the population.

SUBMITTER: O'Bryant SE

PROVIDER: S-EPMC3737282 | biostudies-literature | 2013 Nov

REPOSITORIES: biostudies-literature

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Risk factors for mild cognitive impairment among Mexican Americans.

O'Bryant Sid E SE Johnson Leigh L Reisch Joan J Edwards Melissa M Hall James J Barber Robert R Devous Michael D MD Royall Donald D Singh Meharvan M

Alzheimer's & dementia : the journal of the Alzheimer's Association 20130502 6

<h4>Background</h4>Although a great deal of literature has focused on risk factors for mild cognitive impairment (MCI), little published work examines risk for MCI among Mexican Americans.<h4>Methods</h4>Data from 1628 participants (non-Hispanic n = 1002; Mexican American n = 626) were analyzed from two ongoing studies of cognitive aging and Alzheimer's disease, Project FRONTIER (Facing Rural Obstacles to health Now Through Intervention, Education & Research) and TARCC (Texas Alzheimer's Researc ...[more]

PMID: 23643456

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Project description:BackgroundThe association between stroke and dementia is well established. Less is known about this association in underrepresented ethnic groups. In a large ethnically diverse cohort, we examined whether history of stroke was associated with cognitive impairment, and whether this relationship differed by ethnicity (Mexican American [MA] versus non-Hispanic White).MethodsThis was a population-based cohort study conducted in Nueces County, TX, a biethnic community with a large and primarily nonimmigrant MA population. Residents aged ≥65 were recruited door-to-door or by telephone between May 2018 and December 2021. The primary exposure was history of stroke, obtained by self-report. Demographic, medical, and educational histories were also obtained. The primary outcome was the Montreal Cognitive Assessment (MoCA), a scale that evaluates multiple domains of cognitive performance. Scores were divided into 3 ordinal categories, roughly corresponding to normal cognition (MoCA 26-30), mild cognitive impairment (MoCA 20-25), or probable dementia (MoCA 0-19).ResultsOne thousand eight hundred one participants completed MoCA screening (55% female; 50% MA, 44% Non-Hispanic White, 6% other), of whom 12.4% reported history of stroke. Stroke prevalence was similar across ethnicities (X2 2.1; P=0.34). In a multivariable cumulative logit regression model for the ordinal cognition outcome, a stroke by ethnicity interaction was observed (P=0.01). Models stratified by ethnicity revealed that stroke was associated with cognitive impairment across ethnicities, but had greater impact on cognition in non-Hispanic Whites (cumulative odds ratio=3.81 [95% CI, 2.37-6.12]) than in MAs (cumulative odds ratio=1.58 [95% CI, 1.04-2.41]). Increased age and lower educational attainment were also associated with cognitive impairment, regardless of ethnicity.ConclusionsHistory of stroke was associated with increased odds of cognitive impairment after controlling for other factors in both MA and Non-Hispanic White participants. The magnitude of the impact of stroke on cognition was less in MA than in Non-Hispanic White participants.

Project description:BackgroundRecent evidence from cross-sectional and longitudinal studies supports the hypothesis that sarcopenia is associated with worsening cognitive function. However, primary evidence largely comes from high-income countries, whereas in low- and middle-income countries, this association has been underexplored. This study aimed to estimate the longitudinal association between sarcopenia and mild cognitive impairment in a sample of older Mexican adults.MethodsData come from the three waves of the World Health Organization (WHO) Study on Global AGEing and Adult Health (SAGE) in Mexico (2009, 2014, 2017). Four hundred ninety-six older adults, aged ≥50, were included. Sarcopenia was defined as having low muscle quantity and either/both slow gait speed and weak handgrip strength. Mild cognitive impairment was determined based on the recommendations of the National Institute on Aging-Alzheimer's Association. Cognitive function was evaluated by a composite cognitive score of five different cognitive tests: immediate and delayed recall, forward and backward digit span and semantic verbal fluency. Three-level mixed-effects models (logistic and linear) were used to estimate the longitudinal associations between sarcopenia, mild cognitive impairment and cognitive function.ResultsThe prevalence of mild cognitive impairment (8.9%, 12.9%, 16.0%) and sarcopenia (10.5%, 20.7%, 23.3%) showed a significant temporal increase for Waves 1, 2 and 3 (P-value < 0.01, respectively). The presence of sarcopenia was significantly associated with mild cognitive impairment (OR = 1.74; CI95% 1.02, 2.96; P = 0.04) and worse cognitive function (β = -0.57; CI95% -0.93, -0.21; P < 0.01). We observed significant associations between sarcopenia and immediate verbal recall (β = -0.14; CI95% -0.28, -0.01; P = 0.04), delayed verbal recall (β = -0.12; CI95% -0.23, -0.01; P = 0.03) and semantic verbal fluency (β = -0.17; CI95% -0.28, -0.05; P = 0.01). The prevalence of mild cognitive impairment increased at an annual rate of 0.8% for non-sarcopenic older adults, but nearly 1.5% for sarcopenic adults.ConclusionsSignificant longitudinal associations were observed between sarcopenia, mild cognitive impairment and cognitive function among older Mexican adults. Public health strategies, including policy research and clinical interventions, must be implemented in low- and middle-income countries in order to reduce or delay the onset of sarcopenia and thus improve population-level cognitive health among older adults.

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Risk factors for mild cognitive impairment among Mexican Americans.

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Risk factors for mild cognitive impairment among Mexican Americans.

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