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Baseline cognitive assessment in the Life After 90 Study: A racially/ethnically diverse cohort of people age 90 and older
Author(s) -
Petrosyan Diana,
Demos Asmeret,
Ganzon Czarina,
Popovich Oksana,
Gaied Reham,
Johal Sharan,
Corrada Maria M.M.,
Kawas Claudia H.,
Whitmer Rachel A.,
DeCarli Charles
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.044326
Subject(s) - dementia , gerontology , clinical dementia rating , medicine , ethnic group , cognitive decline , epidemiology , cognition , population , cohort , disease , psychiatry , environmental health , sociology , pathology , anthropology
Background The prevalence of Alzheimer’s disease and related disorders increase with age and is particularly high among the growing segment of oldest‐old (≥90 years). Despite considerable research in this area, a significant gap still exists in the epidemiology of these diseases among ethnic minorities. The LifeAfter90 Study is an ongoing prospective study of long‐term members of Kaiser Permanente Northern California Health Care System (KPNC) older than 90 without a diagnosis of dementia in their medical records. The study aims to explore racial differences in the incidence of cognitive impairment, identify its determinants, and understand the pattern of brain pathologies in an oldest old population of Blacks, Asians, Hispanics and Whites (enrollment goal=800). This abstract presents descriptive analyses of the first 383 participants enrolled. Method Participants receive clinical assessments every 6 months including collection of health history, physical and neurological examination, Clinical Dementia Rating Scale (CDR), Modified Mini‐Mental State Exam (3MS), Functional Activities Questionnaire (FAQ) and Short Physical Performance Battery (SPPB). Result Most individuals had normal cognition (55.4%), were female (63.4%) and white (42.3%) at a mean age of 93.6 years at enrollment (Table). Participants reported their health as generally good, although 11% had dementia at initial evaluation. Individuals with dementia were significantly older. No association was identified between race/ethnicity and cognitive status. Higher education (≥high school diploma) was more common among the normal cognition (NC) group. Participants with mild cognitive impairment and dementia had significantly lower SBBP scores (5.7 and 3.7 respectively) compared to people with NC (6.8). Functional scores due to cognitive difficulties showed the same trend across level of cognitive ability. Surprisingly, vascular disease was more prevalent among individuals with NC (Table). Logistic regression analysis that included age, race/ethnicity, gender, education and SPPB scores, found a high sensitivity and specificity for dementia (ROC=0.96) based on 3MS and cognitive FAQ (Figure). Conclusion The oldest old are a select group of the growing population who may escape major illnesses or delay their onset toward the end of life. Preliminary analysis of this population identifies discrepancies of great importance to be further explored once the enrollment is completed.