Health Disparities in Risks for Cognitive Decline

 
   Lead Investigator:    Travonia Hughes
   Institution      :    Johns Hopkins Bloomberg School of Public Health
   E-Mail           :    thughe17@jhmi.edu
   Proposal ID      :    266



   Proposal Description:
   Abstract:  Evidence from epidemiologic studies suggests that biological risk factors, such as genetics, cardiovascular disease and diabetes may contribute to the disproportionate incidence and prevalence of Mild Cognitive Impairment (MCI), Alzheimer???s disease (AD), and dementia in non-white populations, particularly among African Americans and Hispanics. Few studies have examined differences in the clinical manifestation of dementia among African Americans and Hispanics when compared to non-Hispanic whites. Few studies have examined ethnoracial differences in the progression from normal cognitive functioning to MCI or MCI to dementia in ethnic minority groups. Increased understanding of differential risks for progression of disease among minority older adults may provide clues to potential interventions that can reduce disparities that exist with regard to recognition, diagnosis and treatment (both pharmacologic and non-pharmacologic).    Analysis will employ the NACC Uniform Data Set which contains longitudinal data on family history of dementia, medical, neurological and neuropsychiatric exam findings, neuropsychological test results, functional status and clinical diagnosis. These longitudinal data will provide the opportunity to examine risks for progression of disease. The study will examine differences and similarities among minorities compared to whites, with the goal of identifying risk and protective factors for progression of disease that are similar or different across ethnic groups.     Primary Aims:     1)To examine if known risk and protective factors (e.g., presence of cardiovascular disease, higher levels of education) that are predictors of progression to AD dementia are also predictors of the progression of normal cognition to MCI in the NACC data.    2)To determine if there are significant differences in these predictive factors between minorities and whites.     3)To determine if there are significant differences in the rate of progression from