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Complex interactions underlie racial disparity in the risk of developing Alzheimer's disease dementia
Author(s) -
Xiong Chengjie,
Luo Jingqin,
Coble Dean,
Agboola Folasade,
Kukull Walter,
Morris John C.
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.12060
Subject(s) - dementia , apolipoprotein e , body mass index , gerontology , medicine , demography , disease , alzheimer's disease , longitudinal study , psychology , pathology , sociology
We aim to determine racial disparities and their modifying factors in risk for Alzheimer's disease (AD) dementia among cognitively normal individuals 65 years or older. Methods Longitudinal data from the National Alzheimer's Coordinating Center Uniform Data Set on 1229 African Americans (AAs) and 6679 whites were analyzed for the risk of AD using competing risk models with death as a competing event. Results Major AD risk factors modified racial differences which, when statistically significant, occurred only with older age among APOE ε 4 negative individuals, but also with younger age among APOE ε 4 positive individuals. The racial differences favored AAs among individuals with body mass index (BMI) < 30, but whites among individuals with a high BMI (≥ 30), and were additionally modified by sex, education, hypertension, and smoking status. Conclusions The presence, direction, and relative magnitude of racial disparity for AD represent an interactive function of major AD and cerebrovascular risk factors.