Racial/Ethnic Disparities in Young Adulthood and Midlife Cardiovascular Risk Factors and Late-life Cognitive Domains: The Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE) Study. (April 2021)

• Record Type: Journal Article
• Authors: Peterson, Rachel L.; George, Kristen M.; Gilsanz, Paola; Ackley, Sarah; Mayeda, Elizabeth R.; Glymour, M.M.; Mungas, Dan M.; DeCarli, Charles; Whitmer, Rachel A.
• Is Part Of: Alzheimer disease and associated disorders. Volume 35:Number 2(2021)
• Publication Date: 2021-04
• Subjects: disparities -- cardiovascular risk factors -- life course -- epidemiology -- cohort; Alzheimer's disease -- Periodicals; Dementia -- Periodicals; 616.8305
• DOI: 10.1097/WAD.0000000000000436
• Languages: English
• ISSNs: 0893-0341

Abstract

Abstract : Background: Midlife cardiovascular risk factors (CVRF) increase dementia risk. Less is known about whether CVRF identified before midlife impact late-life cognition in diverse populations. Methods: Linear regression models examined hypertension, hyperlipidemia, and overweight/obesity at ages 30 to 59 with late-life executive function, semantic memory, verbal episodic memory, and global cognition in a cohort of Asians, blacks, Latinos, and whites (n=1127; mean age=75.8, range=65 to 98). Models adjusted for age at CVRF, age at cognitive assessment, sex, race/ethnicity, participant education, and parental education. Results: Overall, 34% had 1 CVRF at ages 30 to 59; 19% had 2+. Blacks (26%) and Latinos (23%) were more likely to have 2+ CVRF than Asians (14%) or whites (13%). Having 2+ CVRF was associated with lower global cognition [β=−0.33; 95% confidence interval (CI)=−0.45, −0.21], executive function (β=−0.26; 95% CI=−0.39, −0.13), verbal episodic memory (β=−0.34; 95% CI=−0.48, −0.20), and semantic memory (β=−0.20; 95% CI=−0.33, −0.07). Interaction by age ( P =0.06) indicated overweight/obesity was negatively associated with executive function at ages 30 to 39 but not at ages 40 to 59. Race/ethnic-specific effects showed disparities in CVRF prevalence impact population disparities in late-life cognition. Conclusion: Being overweight/obese in early adulthood and having 2+ CVRF in early adulthood/midlife are modifiable targets to redress racial/ethnic disparities in cognitive impairment and dementia. Abstract : Supplemental Digital Content is available in the text.