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The effect of global ancestry and diabetes on the 3MS score in older Puerto Ricans
Author(s) -
Tejada Sergio J.,
Rajabli Farid,
Mena Pedro Ramon,
Martin Eden R.,
Rodriguez Vanessa C.,
Celis Katrina,
Adams Larry D.,
Bussies Parker,
Prough Michael,
HamiltonNelson Kara L.,
SilvaVergara Concepcion,
Acosta Heriberto,
Vance Jeffery M.,
FelicianoAstacio Briseida E.,
Beecham Gary W.,
PericakVance Margaret A.,
Cuccaro Michael L.
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.046051
Subject(s) - diabetes mellitus , demography , gerontology , population , gee , medicine , generalized estimating equation , endocrinology , statistics , mathematics , sociology
Background There is limited study of the effect of genetically determined ancestral background and diabetic risk on cognitive status in admixed populations. Puerto Ricans are an admixed population with European (EU), African (AF), and Amerindian (AI) backgrounds. We analyzed the impact of ancestry and diabetes on cognitive status in older Puerto Ricans. Method The dataset consisted of Puerto Ricans > 60 years of age enrolled in the Puerto Rican Alzheimer Diseases Initiative (PRADI). At study entry, all participants were administered the 3MS to screen for cognitive problems. Medical history, including the presence of hypertension, diabetes, and cholesterolemia was also collected at that time. Model building analyses indicated that diabetes was the sole vascular predictor. Admixture proportions were estimated using the ADMIXTURE software. Using a Generalized Estimating Equations (GEE) approach, we modelled the contribution of sex, age at 3MS testing, global ancestry proportion, and diabetes to the participants 3MS score. Result The dataset consisted of 689 Puerto Ricans (70% female) with a mean age at 3MS of 74.9 years (SD=8 years). Mean global ancestry proportions were highest for EU (71%) followed by AF (18%) and AI (11%). As expected, we found significant associations between age, sex, and an age‐sex interaction and the 3MS score. However, we also found significant interactions between ancestry proportions and diabetes as predictors of 3MS score. Specifically, when compared to the effects of combined EU and AI ancestry on the 3MS score, the effect of diabetes on 3MS score is larger in individuals with higher proportions of AF ancestry (p < 0.01). Conclusion Cognitive decline can be secondary to many different deleterious factors. Along with Alzheimer disease, small vessel vascular disease is a major contributor to the development of dementia. Indeed, diabetes affects small blood vessels, and these data support the importance of controlling diabetes in the Puerto Rican population, particularly those with a strong AF ancestry. This highlights the importance of looking for a history of diabetes when evaluating cognition in dementia‐related disorders in Hispanic populations with AF admixture.