Characterization of Mexican Americans with Mild Cognitive Impairment and Alzheimer's Disease

Abstract

Objective To provide characterization of Mexican Americans who meet criteria for Alzheimer’s Disease (AD) and Mild Cognitive Impairment (MCI). Methods 1069 participants ages 40 and above who self-identified as either non-Hispanic white (n=633) or Mexican American (n=436); were recruited using a community-based participatory research (CBPR) approach. Global cognition was assessed via the Mini Mental State Exam (MMSE), dementia severity by the Clinical Dementia Rating Scale (CDR) and depression via the Geriatric Depression Scale 30-item version. Age, gender, education, ApoEε4 allele frequency and diabetic diagnoses were also analyzed. Results Mexican Americans (normal controls, MCI and AD) were younger, less highly educated, performed more poorly on the MMSE, endorsed more symptoms of depression, were more likely to be diagnosed with diabetes, and possessed the ApoEε4 allele less frequently. Age was the only significant risk factor for cognitive dysfunction (AD/MCI) among Mexican Americans (OR=1.06, 95% CI = 1.03–1.09). Age (B=0.07, std=0.02, p<0.001) and ApoEε4 presence (B=0.9, std=0.4, p=0.02) were significantly related to increased disease severity. Conclusions Given the rapidly growing and aging Mexican American population, there is a substantial need for research into cognitive aging, MCI and AD among this ethnic group. The current findings hold important implications for both clinic and research settings and point to additional research needs.

Serum-based Protein Profiles of Alzheimer’s Disease and Mild Cognitive Impairment in Elderly Hispanics

“…This finding is not entirely surprising as the frequency of diabetes and obesity is lower among the Panamanian cohort as compared with Mexican Americans. Additionally, in our future science group www.futuremedicine.com previous work ApoE e4 expression was lower in Mexican Americans with AD (38%) and MCI (26%) [58] than in Panamanians (57 and 50%, respectively), although expression among control subjects is comparable (19-21%). Expression of the ApoE e4 allele has been shown to vary by ethnic group [59], which may contribute to differences in etiology of dementia among different ethnic groups.…”

Vascular Depression and Cognition in Mexican Americans

“…The most common risk factors for developing MCI among this population include diabetes, depression, stroke, and obesity [4, 7-10]. In fact, in our work, depression has been found to be the only consistent risk factor for MCI among Mexican Americans [4, 6] and has been associated with worse cognitive functioning. Cardiovascular conditions and depression are both independently linked to the development of dementia and are a common comorbidity in older individuals.…”

“…The evidence suggests that vascular disease is the underlying link between depression and dementia [39], though further research is needed to elucidate this pathway to dementia. Additionally, most of this research has been conducted in non-Hispanic whites, despite the fact that researchers have evidence to suggest that Mexican Americans have a higher cardiovascular burden [40, 41], higher rates of depression [4, 7, 19], and develop AD at younger ages [6]. Thus, the goal of this study was to contribute to the literature by examining the relationship between vascular risk factors, depression, and cognitive performance in Mexican Americans.…”

“…Research indicates that Mexican Americans are at increased risk for mild cognitive impairment (MCI) and AD [2], suffer from a disproportionate burden of modifiable risk factors [3], are diagnosed at more advanced stages of the disease [4, 5], and develop MCI and AD at younger ages [6] than non-Hispanic whites. The most common risk factors for developing MCI among this population include diabetes, depression, stroke, and obesity [4, 7-10]. In fact, in our work, depression has been found to be the only consistent risk factor for MCI among Mexican Americans [4, 6] and has been associated with worse cognitive functioning.…”

“…In 2050, the number of Hispanics over the age of 65 years will triple [1] and the rate of Alzheimer’s disease (AD) will increase by six-fold [2]. Research indicates that Mexican Americans are at increased risk for mild cognitive impairment (MCI) and AD [2], suffer from a disproportionate burden of modifiable risk factors [3], are diagnosed at more advanced stages of the disease [4, 5], and develop MCI and AD at younger ages [6] than non-Hispanic whites. The most common risk factors for developing MCI among this population include diabetes, depression, stroke, and obesity [4, 7-10].…”