Black and White individuals differ in dementia prevalence, risk factors, and symptomatic presentation

Lennon, Jack C.; Aita, Stephen L.; Bene, Victor A. Del; Rhoads, Tasha; Resch, Zachary J; Eloi, Janelle M; Walker, Keenan A.

doi:10.1002/alz.12509

Cited by 83 publications

(81 citation statements)

References 56 publications

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“…Second, almost all participants in the study were born in Europe, which must be considered, as ethnicity is a known risk factor in different neurodegenerative conditions. 46 Third, the number of participants volunteering for CSF sampling was low in absolute numbers, thus yielding low statistical power. Furthermore, it is possible that stratification of Aβ 42/40 instead of Aβ 42 would have resulted in a more‐specific stratification of participants with Aβ pathology.…”

Section: Discussionmentioning

confidence: 99%

Plasma and CSF NfL are differentially associated with biomarker evidence of neurodegeneration in a community‐based sample of 70‐year‐olds

Dittrich

Ashton

Zetterberg

et al. 2022

Alz & Dem Diag Ass & Dis Mo

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Neurofilament light protein (NfL) in cerebrospinal fluid (CSF) and plasma (P) are suggested to be interchangeable markers of neurodegeneration. However, evidence is scarce from community‐based samples. NfL was examined in a small‐scale sample of 287 individuals from the Gothenburg H70 Birth cohort 1944 study, using linear models in relation to CSF and magnetic resonance imaging (MRI) biomarker evidence of neurodegeneration. CSF‐NfL and P‐NfL present distinct associations with biomarker evidence of Alzheimer's disease (AD) pathology and neurodegeneration. P‐NfL was associated with several markers that are characteristic of AD, including smaller hippocampal volumes, amyloid beta (Aβ) 42 , Aβ 42/40 , and Aβ 42 /t‐tau (total tau). CSF‐NfL demonstrated associations with measures of synaptic and neurodegeneration, including t‐tau, phosphorylated tau (p‐tau), and neurogranin. Our findings suggest that P‐NfL and CSF‐NfL may exert different effects on markers of neurodegeneration in a small‐scale community‐based sample of 70‐year‐olds.

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Section: Discussionmentioning

confidence: 99%

Plasma and CSF NfL are differentially associated with biomarker evidence of neurodegeneration in a community‐based sample of 70‐year‐olds

Dittrich

Ashton

Zetterberg

et al. 2022

Alz & Dem Diag Ass & Dis Mo

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“…For example, in areas that benefit from sustained economic growth (e.g., "Silicon Valley"), which may form advantaged clusters and outliers, we find favorable mortality for diabetes and chronic lower respiratory disease. Likewise, we find that class and race may intersect for Alzheimer's disease, which is not only of higher prevalence among African American/Black populations and underdiagnosed as well 34 . Finally, we find that place and race intersect in the western US, with higher county whiteness as well as rates of suicide 35 and other "deaths of despair" 36 .…”

Section: Discussionmentioning

confidence: 61%

Race, class, and place modify mortality rates for the top 12 causes of death in the United States, 1999-2021

Formanack

Doshi

Valdez

et al. 2022

Preprint

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ObjectivesTo disarticulate the associations of race (whiteness), class (socioeconomic status), and place (county) with risk of cause-specific death in the US.MethodsWe studied mortality in US counties for 11 causes of death (1999-2019) and COVID-19 (2020-2021). We adjusted for race and age using the American Community Survey and socioeconomic status using the Area Deprivation Index. Bayesian regressions with spatial county effects were estimated for inference.ResultsCounty whiteness and socioeconomic status modified death rates; geospatial effects differed by cause of death. Other factors equal, a 20% increase in county whiteness was associated with 5-8% increase in death from three causes and 4-15% reduction in death from others, including COVID-19. Other factors equal, advantaged counties had significantly lower death rates, even when juxtaposed with disadvantaged ones. Geospatial patterns of residual risk varied by cause of death. For example, cancer and heart disease death rates were better explained by age, socioeconomic status, and county whiteness than were COVID-19 and suicide deaths.ConclusionsThere are important independent contributions from race, class, and geography to risk of death in the US.

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“…However, contrary to our hypothesis, we found that Black individuals were not more vulnerable to the effect of everyday discrimination in this respect. Although some research suggests that Black individuals are diagnosed with AD 1.33 to 1.50 times more often than whites ( Akushevich et al, 2020 ; Matthews et al, 2019 ; Mayeda et al, 2016 ), other research suggests that Black individuals are 30% less likely to receive a diagnosis (e.g., Lennon et al, 2021 ). We found that there were not race differences in either of these directions regarding the percentage of respondents who had AD at follow-up and that everyday discrimination did not have a stronger effect for Black respondents.…”

Section: Discussionmentioning

confidence: 99%

Does the Chronic Stress of Everyday Discrimination or Race Itself Better Predict AD Onset Risk?

Gary

Hoque

Yashkin

et al. 2022

Gerontology and Geriatric Medicine

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Using evidence from the Health and Retirement Study, we explore racial disparities in Alzheimer’s Disease (AD) onset risk. From a stress process perspective, there is substantial evidence in the literature that everyday discrimination is a chronic strain for Black individuals that acts as a social determinant of illness. However, few studies have examined specific relationships between this social stressor, race, and AD onset risk. Using Cox Proportional Hazard Models, we examined racial differences in exposure and vulnerability to everyday discrimination. Findings suggest that everyday discrimination predicts AD onset risk, and Black individuals experience more frequent exposure to everyday discrimination as a chronic strain. However, contrary to the stress process model, Black respondents were not more vulnerable to the effect of everyday discrimination on AD onset risk. Racial bias from medical professionals during the diagnostic process and mortality selection bias may explain this effect. Overall, the results of this study provide further evidence that discrimination is a key factor in predicting AD while also considering that many racial minorities with high rates of this type of social stress may not receive an unbiased diagnosis and/or survive to late life to develop AD.

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Black and White individuals differ in dementia prevalence, risk factors, and symptomatic presentation

Cited by 83 publications

References 56 publications

Plasma and CSF NfL are differentially associated with biomarker evidence of neurodegeneration in a community‐based sample of 70‐year‐olds

Plasma and CSF NfL are differentially associated with biomarker evidence of neurodegeneration in a community‐based sample of 70‐year‐olds

Race, class, and place modify mortality rates for the top 12 causes of death in the United States, 1999-2021

Does the Chronic Stress of Everyday Discrimination or Race Itself Better Predict AD Onset Risk?

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