Disparate dementia risk factors associate with cognitive impairment and rates of decline in African Americans.

Evaluate the frequency of modifiable dementia risk factors and association with cognitive impairment and rate of decline in diverse participants engaged in studies of memory and aging. Modifiable dementia risk factors and their associations with cognitive impairment and cognitive decline were determined in community-dwelling African American (AA, n=261) and non-Hispanic White participants (nHW, n=193) who completed ≥2 visits at the Mayo Clinic Alzheimer Disease Research Center in Jacksonville, Florida. Risk factors and their associations with cognitive impairment (global Clinical Dementia Rating® [CDR] ≥0.5) and rates of decline (CDR Sum-of-Boxes) in impaired participants were compared in AA and nHW participants, controlling for demographics, APOE ɛ4 status, and Area Deprivation Index. Hypertension, hypercholesterolemia, obesity, and diabetes were overrepresented in AA participants, but were not associated with cognitive impairment. Depression was associated with increased odds of cognitive impairment in AA (OR: 4.30; 95%CI: 2.13-8.67) and nHW participants (OR: 2.79; 95%CI: 1.21-6.44) but uniquely associated with faster decline in AA participants (β: 1.71; 95%CI: 0.69-2.73; p=0.001). Fewer AA participants reported antidepressant use (9/49, 18%) than nHW counterparts (57/78, 73%; p<0.001). Vitamin B12 deficiency was also associated with an increased rate of cognitive decline in AA (β: 2.65; 95%CI: 0.38-4.91; p=0.023). Modifiable dementia risk factors are common in AA and nHW participants, representing important risk mitigation targets. Depression was associated with dementia in AA and nHW participants, and with accelerated declines in cognitive function in AA participants. Optimizing depression screening and treatment may improve cognitive trajectories and outcomes in AA participants. This article is protected by copyright. All rights reserved.

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This article is protected by copyright. All rights reserved.