P1-615: DEMOGRAPHIC AND REFERRAL DIFFERENCES BETWEEN WHITES AND NATIVE AMERICANS ENROLLED IN THE ALZHEIMER'S DISEASE CENTERS: CONSIDERATIONS WHEN EXAMINING THE RACIAL DIFFERENCES IN INCIDENT DEMENTIA

ABSTRACTBackground:Memory impairment in geriatric depression is understudied, but may identify individuals at risk for development of dementia and Alzheimer's disease (AD). Using a neuropsychologically based definition of amnestic mild cognitive impairment (aMCI) in patients with geriatric depression, we hypothesized that patients with aMCI, compared with those without it, would have increased incidence of both dementia and AD.Methods:Participants were aged 60 years and older and consisted of depressed participants and non-depressed volunteer controls. The depressed cohort met criteria for unipolar major depression. All participants were free of dementia and other neurological illness at baseline. At study entry, participants were administered a standardized clinical interview, a battery of neurocognitive tests, and provided a blood sample for determination of apolipoprotein E genotype. A cognitive diagnosis was assigned by a panel of experts who convened annually and reviewed available clinical, neuropsychological and laboratory data to achieve a consensus cognitive diagnosis to determine a consensus diagnosis. Survival analysis examined the association between aMCI and later dementia (all-cause) and AD.Results:Among 295 depressed individuals, 63 (21.36%) met criteria for aMCI. Among 161 non-depressed controls, four (2.48%) met aMCI criteria. Participants were followed for 6.28 years on average. Forty-three individuals developed dementia, including 40 (13.6%) depressed and three (1.9%) control participants. Both aMCI and age were associated with incident dementia and AD.Conclusions:The presence of aMCI is a poor prognostic sign among patients with geriatric depression. Clinicians should carefully screen elderly depressed adults for memory impairment.

Download Full-text

Perceived Stress is Associated with Alzheimer’s Disease Cerebrospinal Fluid Biomarkers in African Americans with Mild Cognitive Impairment

Journal of Alzheimer s Disease ◽

10.3233/jad-200089 ◽

2020 ◽

Vol 77 (2) ◽

pp. 843-853

Author(s):

Antoine R. Trammell ◽

Darius J. McDaniel ◽

Malik Obideen ◽

Maureen Okafor ◽

Tiffany L. Thomas ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cerebrospinal Fluid ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

African Americans ◽

Racial Differences ◽

Perceived Stress ◽

Cross Sectional Study ◽

Cross Sectional

Background: African Americans (AA) have a higher Alzheimer’s disease (AD) prevalence and report more perceived stress than White Americans. The biological basis of the stress-AD link is unclear. This study investigates the connection between stress and AD biomarkers in a biracial cohort. Objective: Establish biomarker evidence for the observed association between stress and AD, especially in AA. Methods: A cross-sectional study (n = 364, 41.8% AA) administering cognitive tests and the perceived stress scale (PSS) questionnaire. A subset (n = 309) provided cerebrospinal fluid for measurement of Aβ42, Tau, Ptau, Tau/Aβ42 (TAR), and Ptau/Aβ42 (PTAR). Multivariate linear regression, including factors that confound racial differences in AD, was performed. Results: Higher PSS scores were associated with higher Ptau (β= 0.43, p = 0.01) and PTAR (β= 0.005, p = 0.03) in AA with impaired cognition (mild cognitive impairment). Conclusion: Higher PSS scores were associated with Tau-related AD biomarker indices in AA/MCI, suggesting a potential biological connection for stress with AD and its racial disparity.

Download Full-text

Antihypertensive medications and risk for incident dementia and Alzheimer's disease: a meta-analysis of individual participant data from prospective cohort studies

The Lancet Neurology ◽

10.1016/s1474-4422(19)30393-x ◽

2020 ◽

Vol 19 (1) ◽

pp. 61-70 ◽

Cited By ~ 24

Author(s):

Jie Ding ◽

Kendra L Davis-Plourde ◽

Sanaz Sedaghat ◽

Phillip J Tully ◽

Wanmei Wang ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cohort Studies ◽

Prospective Cohort ◽

Meta Analysis ◽

Individual Participant Data ◽

Antihypertensive Medications ◽

Prospective Cohort Studies ◽

Incident Dementia ◽

Individual Participant

Download Full-text

P3-006: Racial Differences in Willingness to Enroll in Preclinical Alzheimer's Disease Clinical Trials

Alzheimer s & Dementia ◽

10.1016/j.jalz.2016.06.1663 ◽

2016 ◽

Vol 12 ◽

pp. P819-P820

Author(s):

Yan Zhou ◽

David Elashoff ◽

Sarah Kremen ◽

Edmond Teng ◽

Jason Karlawish ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Clinical Trials ◽

Racial Differences ◽

Preclinical Alzheimer’S Disease

Download Full-text

Comparison of Alzheimer's Disease in Native Americans and Whites

International Psychogeriatrics ◽

10.1017/s104161020300961x ◽

2003 ◽

Vol 15 (4) ◽

pp. 367-375 ◽

Cited By ~ 12

Author(s):

Myron F. Weiner ◽

Roger N. Rosenberg ◽

Doris Svetlik ◽

Linda S. Hynan ◽

Kyle B. Womack ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Native American ◽

Native Americans ◽

Age At Onset ◽

Course Of Illness ◽

University Of Texas ◽

Disease Clinic ◽

Prevalence Of Depression ◽

The University

Objective: This study compared medical history and findings on initial clinical examination in Native Americans diagnosed with possible or probable Alzheimer's disease (AD) at Native American satellite clinics of the University of Texas (UT) Southwestern Medical Center's Alzheimer's Disease Center with those of Whites diagnosed with probable AD at the UT Southwestern Medical Center's Alzheimer's Disease Clinic. Methods: The information reviewed was contained in the database of the UT Southwestern Alzheimer's Disease Center. Results: In relation to Whites, Native Americans had slightly but significantly greater age at onset of symptoms (71.7 vs. 69.6 years, t = −2.08, p = .04) and equivalent cognitive scores at evaluation (Mini-Mental State Exam score = 17.4 vs. 18.5, t = 0.98, p = .33), despite significantly lower educational level (11.4 vs. 13.4 years, t = 5.63, p < .001). Native Americans were more frequently depressed on examination (22.8% vs. 9.5%, χ2 = 12, p = .001) and reported diabetes, hypertension, and heart disease significantly more often than did Whites (p < .01 for all), but their survival time after AD diagnosis was similar to that of Whites despite these comorbidities. Conclusions: With the exception of a greater prevalence of depression and cardiovascular risk factors in Native Americans than in Whites, Native Americans had a course of illness similar to that of Whites.

Download Full-text

Racial differences in biomarkers of Alzheimer’s disease and inflammation

Alzheimer s & Dementia ◽

10.1002/alz.052843 ◽

2021 ◽

Vol 17 (S5) ◽

Author(s):

William T. Hu ◽

Whitney Wharton ◽

Monica W. Parker

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Racial Differences

Download Full-text

Racial Differences in the Pathway to Diagnosis of Alzheimer's Disease and Related Dementias

Innovation in Aging ◽

10.1093/geroni/igab046.1082 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 280-280

Author(s):

James Burke ◽

Matthew Dupre ◽

Se Hee Min ◽

Ruth Anderson ◽

David Page ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Older Adults ◽

Alzheimer's Disease ◽

Racial Differences ◽

Primary Diagnosis ◽

Health Records ◽

Black And White ◽

Clinical Encounters ◽

To Receive ◽

Hispanic White

Abstract This study examined differences in the pathway to diagnosis of Alzheimer's disease and related dementias (ADRD) between Black and White older adults. Using electronic health records from a large health system, we included 2,085 non-Hispanic Black and 6,269 non-Hispanic White older adults with a final/primary diagnosis of ADRD between 2014 and 2020. Black older adults were more likely to receive the ADRD diagnosis from a primary care provider (35.4% vs. 29.8%), during a hospital admission (19.5% vs. 13.6%), or during an emergency department visit (4.2% vs. 2.0%); but were less likely to be diagnosed by an ADRD specialist (31.6% vs. 45.2%). Black older adults had nearly twice as many clinical encounters in the two years prior to the ADRD diagnosis than their White counterparts (43 vs. 26). Despite having more clinical encounters, Black older adults were more likely to be at a later stage when diagnosed than White older adults.

Download Full-text