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Association between enrollment factors and incident cognitive impairment in Blacks and Whites: Data from the Alzheimer's Disease Center
Author(s) -
Gleason Carey E.,
Norton Derek,
Zuelsdorff Megan,
Benton Susan F.,
Wyman Mary F.,
Nystrom Naomi,
Lambrou Nickolas,
Salazar Hector,
Koscik Rebecca L.,
Jonaitis Erin,
Carter Fabu,
Harris Brieanna,
Gee Alexander,
Chin Nathaniel,
Ketchum Frederick,
Johnson Sterling C.,
Edwards Dorothy F.,
Carlsson Cynthia M.,
Kukull Walter,
Asthana Sanjay
Publication year - 2019
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 - 10.1016/j.jalz.2019.07.015
Subject(s) - dementia , race (biology) , gerontology , cognition , disease , demography , cognitive impairment , medicine , extant taxon , association (psychology) , health and retirement study , clinical psychology , psychology , psychiatry , botany , evolutionary biology , sociology , psychotherapist , biology
We examined the influence of enrollment factors demonstrated to differ by race on incident mild cognitive impairment and dementia using Alzheimer's Disease Center data. Methods Differences in rates of incident impairment between non‐Latino Whites and Blacks ( n = 12,242) were examined with age‐at‐progression survival models. Models included race, sex, education, source of recruitment, health factors, and family history of dementia. Results No significant race differences in progression were observed in cognitively unimpaired participants. In those with mild cognitive impairment at baseline, Whites evidenced greater risk for progression than Blacks. Enrollment factors, for example, referral source, were significantly related to progression. Discussion The finding that Blacks demonstrated lower rate of progression than Whites is contrary to the extant literature. Nested‐regression analyses suggested that selection‐related factors, differing by race, may account for these findings and influence our ability to accurately estimate risk for progression. It is potentially problematic to make racial comparisons using Alzheimer's Disease Center data sets.