Premium
Socioeconomic determinants of dementia in Caribbean Hispanics: An international comparison
Author(s) -
LlibreGuerra Jorge J,
Li Jing,
Harrati Amal,
JiménezVelazquez Ivonne Z.,
Acosta Daisy,
Llibre Juan,
Liu MaoMei,
Dow William H
Publication year - 2020
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.038313
Subject(s) - dementia , socioeconomic status , demography , gerontology , medicine , caribbean region , population , afro caribbean , geography , disease , environmental health , latin americans , sociology , linguistics , philosophy , pathology , political science , law
Abstract Background Hispanics populations in the U.S. are more likely to develop dementia than non‐Hispanic White populations; among Hispanics, those with Caribbean origin seem to carry the higher risk for developing dementia. However, little is known about how various social risk factors for dementia differentially affect non‐Hispanic Whites and Hispanics of Caribbean origin in the U.S., or between those living in the main Caribbean islands. The present study aimed to examine the associations of socioeconomic determinants(SES) with dementia across Puerto Rico, Cuba and the Dominican Republic and compared with similar populations living in U.S. Method Using a community‐dwelling population of Caribbean older adults ages 65+ from Puerto Rico, Dominican Republic, and Cuba, enrolled in the 10/66 study we determined dementia prevalence on the main Caribbean Islands using the 10/66 dementia algorithm. Associations between socioeconomic risk factors and prevalent dementia were estimated using linear probability models, stratified by gender and age. We then compared results from the main islands with Hispanic and non‐Hispanic populations living in US enrolled in the U.S. Health and Retirement Study, using the TICS dementia algorithm. Result The prevalence of dementia was high: 10.9% in Cuba and 11.7% in Puerto Rico and the Dominican Republic (95% CI, 9.8‐12.1). We found overall weaker associations between education and dementia in the three main Caribbean islands. By contrast, a stronger association between education and dementia was found in the US among non‐Hispanic whites, Mexican Hispanics, and non‐Mexican Hispanics; these persist after controlling for income and wealth(p<0.001). In both the US and in the Caribbean islands, working in a blue collar occupation as opposed to white collar occupation was associated with a higher risk of dementia(p=0.001), and higher income was negatively associated with dementia for both genders(p=0.001), although these associations were stronger in the U.S. Conclusion The prevalence of dementia in the older Caribbean population is high, both in the main islands and in US compared to non‐Hispanic‐whites. There were differential associations between SES risk factors, particularly education, and dementia probability between Caribbean islands and the U.S., which may be attributed to differences across societies in risk factors correlated with education.