Differential Impact of Stroke on Cognitive Impairment in Mexican Americans and Non-Hispanic White Americans.


Journal

Stroke
ISSN: 1524-4628
Titre abrégé: Stroke
Pays: United States
ID NLM: 0235266

Informations de publication

Date de publication:
11 2022
Historique:
pubmed: 13 8 2022
medline: 27 10 2022
entrez: 12 8 2022
Statut: ppublish

Résumé

The 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). This 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). One 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 (X History 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.

Sections du résumé

BACKGROUND
The 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).
METHODS
This 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).
RESULTS
One 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 (X
CONCLUSIONS
History 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.

Identifiants

pubmed: 35959679
doi: 10.1161/STROKEAHA.122.039533
pmc: PMC9613525
mid: NIHMS1824882
doi:

Types de publication

Journal Article Research Support, N.I.H., Extramural

Langues

eng

Sous-ensembles de citation

IM

Pagination

3394-3400

Subventions

Organisme : NINDS NIH HHS
ID : K01 NS117555
Pays : United States
Organisme : NIA NIH HHS
ID : P30 AG024824
Pays : United States
Organisme : NINDS NIH HHS
ID : R01 NS100687
Pays : United States
Organisme : NIA NIH HHS
ID : RF1 AG068410
Pays : United States

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Auteurs

Christopher J Becker (CJ)

Department of Neurology (C.J.B., D.A.L., N.G., R.L., M.V.S., D.B.Z., L.B.M.), University of Michigan Medical School, Ann Arbor.

Steven G Heeringa (SG)

Institute for Social Research, University of Michigan, Ann Arbor (S.G.H., W.C., K.M.L.).

Wen Chang (W)

Institute for Social Research, University of Michigan, Ann Arbor (S.G.H., W.C., K.M.L.).

Emily M Briceño (EM)

Department of Physical Medicine and Rehabilitation (E.M.B.), University of Michigan Medical School, Ann Arbor.
Institute for Social Research, University of Michigan, Ann Arbor (S.G.H., W.C., K.M.L.).

Roshanak Mehdipanah (R)

Department of Health Behavior and Health Education (R.M.), University of Michigan School of Public Health, Ann Arbor.

Deborah A Levine (DA)

Department of Neurology (C.J.B., D.A.L., N.G., R.L., M.V.S., D.B.Z., L.B.M.), University of Michigan Medical School, Ann Arbor.
Department of Internal Medicine (D.A.L., K.M.L.), University of Michigan Medical School, Ann Arbor.

Kenneth M Langa (KM)

Department of Internal Medicine (D.A.L., K.M.L.), University of Michigan Medical School, Ann Arbor.

Xavier F Gonzales (XF)

Corpus Christi Health Department, TX (X.F.G.).

Nelda Garcia (N)

Department of Neurology (C.J.B., D.A.L., N.G., R.L., M.V.S., D.B.Z., L.B.M.), University of Michigan Medical School, Ann Arbor.

Ruth Longoria (R)

Department of Neurology (C.J.B., D.A.L., N.G., R.L., M.V.S., D.B.Z., L.B.M.), University of Michigan Medical School, Ann Arbor.

Mellanie V Springer (MV)

Department of Neurology (C.J.B., D.A.L., N.G., R.L., M.V.S., D.B.Z., L.B.M.), University of Michigan Medical School, Ann Arbor.

Darin B Zahuranec (DB)

Department of Neurology (C.J.B., D.A.L., N.G., R.L., M.V.S., D.B.Z., L.B.M.), University of Michigan Medical School, Ann Arbor.

Lewis B Morgenstern (LB)

Department of Neurology (C.J.B., D.A.L., N.G., R.L., M.V.S., D.B.Z., L.B.M.), University of Michigan Medical School, Ann Arbor.
Center for Social Epidemiology and Population Health (L.B.M.), University of Michigan School of Public Health, Ann Arbor.

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