Objectives U.S. Latino populations are diverse. Research on racial identity, skin tone and Latino health is imperative for understanding and combatting racism and colorism. We examined differences in memory performance: among non-Latinos and Latinos who identified as Black, other and white in the U.S.; and then among Puerto Ricans in Boston whose skin tones ranged from dark, medium, light to ‘white’. Methods We used 2010 Health and Retirement Study and 2004 Boston Puerto Rican Health Survey data, respectively, to examine racial and color differences in memory performance among 50+ year older adults in the U.S. and Puerto Rican older adults in Boston. We applied OLS regression to immediate and delayed word recall test scores and adjusted for education, health conditions and health behaviors. Results In adjusted models, white non-Latinos had better memory performance than white Latinos. Black Latinos, other Latinos, and Black non-Latinos had lower delayed word recall scores than white Latinos. Black Latinos and Black non-Latinos had similar scores. Intra-Latino racial disparities endured despite inclusion of education and other covariates. Among Puerto Ricans in Boston, medium-toned individuals had higher scores than ‘white’-toned individuals. Discussion Findings support the importance of examining self-identified race and skin tone in Latino aging research. Further investigation is needed to understand the stubborn intra-Latino racial disparities in memory performance and surprising adverse cognitive performance among ‘white’-toned relative to darker-toned Puerto Ricans in Boston.
Alzheimer’s disease (AD) and dementia has emerged as a significant societal issue and a global priority. The prevalence of dementia is rising more rapidly in low and middle income countries (LMIC) than in high income countries. A growing body of evidence shows that prevention through risk factor management is the key to reducing the burden of dementia in the society, especially in LMIC. However, a one-size-fits all approach to health promotion is neither efficient nor effective. Latin American countries (LAC) have unique challenges related to dementia, including rapid aging population, high admixture degree and risk factors profile, which influence the prevalence and presentation of dementia. During this session, we will present findings and tools that will help tailor and personalize risk factor management in Hispanics populations. Participants will be first introduced to genetics of Alzheimer disease in Hispanic populations relative to non-Hispanics and the influence of gene by environment interactions. The second presentation will report on the epidemiology and risk factors of AD using cross countries/society comparisons (Non-Hispanics whites vs Hispanics living in US vs Hispanics living in Latin America.) The third presenter will discuss the development of a tool that visualizes how each risk factor contributes to the risk of dementia and how one may lower their risk by addressing the risk factors. The tool can be used in primary care settings in Cuba, Dominican Republic and Puerto Rico. Finally, the fourth presenter uses state-of-the-art digital assessment tools (brain health assessment), for low-cost monitoring of cognitive functioning, MCI and dementia. Such instruments are important for future evaluation of the impact of preventive strategies. At the end of the presentations, attendees will be able to identify the unique genetic and social determinants that drive AD in LAC. Recommendations will be given for preventive strategies tailored to LMIC. The findings to be shared will be essential for building evidence-based interventions tailored to reducing the burden of dementia in the Hispanic populations.Session Chair:Juan Llibre RodriguezAlzheimer Disease and genetics in Hispanic PopulationsJorge J Llibre-GuerraAlzheimer disease epidemiology and risk factors in Caribbean and non-Caribbean Hispanics populations.Ivonne Z. Jiménez VelázquezDevelopment of a tool to motivate for healthy behaviors to prevent dementia in the Caribbean.Daisy AcostaA brief digital cognitive assessment for detection of cognitive impairment in Hispanics populations.Ana Rodriguez-Salgado
BackgroundLatin America and the Caribbean (LAC) countries are experiencing unprecedentedly rapid demographic ageing. Growing evidence shows that cardiovascular health (CVH) is associated with brain health. Little is known about this topic among older adults in Latin America, where the number of people living with dementia is rising. The present study aimed to examine the prevalence, incidence and associations of socioeconomic determinants and cardiovascular risk factors with dementia across six LAC countries.MethodsThe 10/66 Dementia Research Group has carried out population‐based catchment area surveys, using a common protocol, in six Latin‐American countries Cuba, Dominican Republic, Mexico, Peru, Puerto Rico and Venezuela of all over 65 year old (n = 12 704). An incidence wave was conducted 4 ‐5 years after cohort inception, 8 502 participants were reinter viewed, contributing 34 000 person‐years of follow‐up. The outcomes were 10/66 dementia and DSM IV dementia. An index of modifiable CVH factors (ranging from 0 to 14) was calculated. Incident dementia was modeled using competing risks regression to adjust for risk of death.ResultsThe prevalence of dementia varied widely across different countries, ranging from 4.8% in Peru and 11.7% in Puerto Rico and the Dominican Republic. Incidence of 10/66 dementia varied between 18.2 (95% CI 14.3‐23.0) per 1000 person‐years in Peru to 30.4 (25.5‐36.3) per 1000 person‐years in Mexico. Being male, having higher education and younger age were all protective of dementia. Specific cognitive tests including literacy, verbal fluency and motor sequencing had also similar protective associations with dementia, providing more supporting evidence for the cognitive reserve hypothesis. Compared to poor CVH, participants with moderate and ideal levels of CVH had a significantly lower risk of dementia both in the unadjusted (subhazard ratio for moderate: 0.77; ideal: 0.59) and adjusted models (moderate: 0.73; ideal: 0.66).ConclusionsThe prevalence of dementia in the older Latin American and Caribbean population is high. Moderate and ideal levels of CVH in old age may protect against dementia incidence. These findings may inform health promotion efforts within dementia national plans adopted recently in some Latin American countries
Alzheimer’s disease (AD) and dementia has emerged as a significant societal issue and a global priority. The prevalence of dementia is rising more rapidly in low and middle income countries (LMIC) than in high income countries. Yet, knowledge of dementia risk factors is dominated by research from high income countries (HIC), which cannot be readily translated to LMIC. Latin American countries (LAC) have unique challenges related to dementia, including rapid aging population, high admixture degree and risk factors profile, which influence the prevalence and presentation of dementia. Several epidemiological studies during the past decade have shown a rapid increase of dementia in LAC, but the impact of genetic, protective and risk factors remain poorly understood. This research session will feature a series of short and engaging talks about new trends of dementia in the region and will answer key questions regarding dementia determinants and consequences in Hispanic populations. Participants will be first introduced to the aging process in LAC, prevalence and incidence of dementia within the region. The second presentation will report on genetics of Alzheimer disease in Hispanic populations. The third presenter will discuss the complexities of dementia multimorbidity and the impact of neuropsychiatric symptoms. The fourth presenter will discuss about Nationals and Regional Strategies to address dementia and reflects on recommendations and future directions for the region. All presentations will be based on findings from multiple research projects across the region. Furthermore, presenters will extended comparison to Non-Hispanics whites and Hispanics populations living in US, which allows cross countries/society comparisons. Overall, new information about dementia will be shared with the audience. Attendees will be able to identify the unique genetic and social determinants that drive AD in LAC. Recommendations will be given for preventive strategies tailored to LMIC. The findings to be shared will be essential for building evidence-based interventions that achieve the goals of the National Plan to Address Alzheimer’s Disease.
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