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The role of co‐morbid hypertension and depression on cognitive and proteomic outcomes among Mexican Americans
Author(s) -
Large Stephanie E.,
Davila Marcela,
Petersen Melissa,
Hall James R.,
O'Bryant Sid,
Davis Sandra E.,
Johnson Leigh Ann
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.045956
Subject(s) - depression (economics) , comorbidity , cognitive decline , medicine , cognition , late life depression , population , disease , psychology , dementia , psychiatry , gerontology , economics , macroeconomics , environmental health
Background Medical comorbidities are commonly associated with poorer cognition. Hypertension and depression are common comorbidities linked to cognitive decline and Alzheimer’s disease (AD). Mexican Americans experience higher rates of these medical comorbidities and also present with cognitive decline at younger ages as compared to their non‐Hispanic White counterparts. Increased work has expanded to look at reasons for increased risk for neurodegenerative conditions such as AD specifically among this population. The purpose of this study was to examine the role of co‐morbid hypertension and depression on cognitive and proteomic outcomes. Method Data from 548 Mexican Americans (415 normal control, 133 MCI/AD) was collected from a community based epidemiological study of aging. The average age was 61 and the average education was 7.7 years. Participants were stratified into 4 groups: no hypertension or depression (N= 101), hypertension only (N= 218), depression only (N=59), and comorbid hypertension and depression (N=170). One‐way ANOVAs were utilized to examine group differences in cognitive performance and proteomics. Cognition was assessed via WMSIII Logical memory 1 & 2, Trails A/B, EXIT, and MMSE. Biomarkers of inflammation (serum TNFα, IL5, IL6, IL7, IL10 and CRP) and neurodegeneration (plasma Aß42/ Aß40, Tau, NFL) were analyzed. A logistic regression was calculated with normal control versus MCI/AD as the outcome variable and comorbid condition, education and age as predicting variables. Result In normal controls, comorbid hypertension and depression was significantly associated with poorer executive and global cognitive function; and this comorbidity increased risk of MCI/AD diagnosis (OR= 1.950; 95/5 CI= 1.23‐3.08). Among normal controls, the comorbid group was found to have significantly higher levels of NFL (p<0.032) and IL6 (p<0.018) than the depression only group. Among those with MCI/AD, the comorbid group had significantly higher NFL levels (p<0.002) than the neither condition group. Conclusion The results of the study demonstrated that comorbid hypertension and depression was related to poorer cognitive functioning and increased risk for cognitive impairment among Mexican Americans. Findings support that medical conditions likely influence biomarkers of inflammation and neurodegeneration, which lends support for a precision medicine approach to treating MCI and AD specifically among minority populations.