Association Between Enrollment Factors and Incident Cognitive Impairment in Blacks and Whites: Data from the Alzheimer's Disease Center

Overview

Journal Alzheimers Dement

Specialties Neurology
Psychiatry

Date 2019 Oct 12

PMID 31601516

Citations 59

Authors

Carey E Gleason

Derek Norton

Megan Zuelsdorff

Susan F Benton

Mary F Wyman

Naomi Nystrom

Nickolas Lambrou

Hector Salazar

Rebecca L Koscik

Erin Jonaitis

Fabu Carter

Brieanna Harris

Alexander Gee

Nathaniel Chin

Frederick Ketchum

Sterling C Johnson

Dorothy F Edwards

Cynthia M Carlsson

Walter Kukull

Sanjay Asthana

Affiliations

Soon will be listed here.

Abstract

Introduction: We examined the influence of enrollment factors demonstrated to differ by race on incident mild cognitive impairment and dementia using Alzheimer's Disease Center data.

Methods: Differences in rates of incident impairment between non-Latino Whites and Blacks (n = 12,242) were examined with age-at-progression survival models. Models included race, sex, education, source of recruitment, health factors, and family history of dementia.

Results: No significant race differences in progression were observed in cognitively unimpaired participants. In those with mild cognitive impairment at baseline, Whites evidenced greater risk for progression than Blacks. Enrollment factors, for example, referral source, were significantly related to progression.

Discussion: The finding that Blacks demonstrated lower rate of progression than Whites is contrary to the extant literature. Nested-regression analyses suggested that selection-related factors, differing by race, may account for these findings and influence our ability to accurately estimate risk for progression. It is potentially problematic to make racial comparisons using Alzheimer's Disease Center data sets.

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