Diabetes, Cognitive Decline, and Mild Cognitive Impairment Among Diverse Hispanics/Latinos: Study of Latinos–Investigation of Neurocognitive Aging Results (HCHS/SOL)

Abstract

OBJECTIVEHispanics/Latinos are the largest ethnic/racial group in the U.S., have the highest prevalence of diabetes, and are at increased risk for neurodegenerative disorders. Currently, little is known about the relationship between diabetes and cognitive decline and disorders among diverse Hispanics/Latinos. The purpose of this study is to clarify these relationships in diverse middle-aged and older Hispanics/Latinos. RESEARCH DESIGN AND METHODSThe Study of Latinos-Investigation of Neurocognitive Aging (SOL-INCA) is an ancillary study of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). HCHS/ SOL is a multisite (Bronx, NY; Chicago, IL; Miami, FL; and San Diego, CA), probabilitysampled (i.e., representative of targeted populations), and prospective cohort study. Between 2016 and 2018, SOL-INCA enrolled diverse Hispanics/Latinos aged ‡50 years (n 5 6,377). Global cognitive decline and mild cognitive impairment (MCI) were the primary outcomes. RESULTSPrevalent diabetes at visit 1, but not incident diabetes at visit 2, was associated with significantly steeper global cognitive decline (b GC 520.16 [95% CI 20.25; 20.07]; P < 0.001), domain-specific cognitive decline, and higher odds of MCI (odds ratio 1.74 [95% CI 1.34; 2.26]; P < 0.001) compared with no diabetes in age-and sex-adjusted models. CONCLUSIONSDiabetes was associated with cognitive decline and increased MCI prevalence among diverse Hispanics/Latinos, primarily among those with prevalent diabetes at visit 1. Our findings suggest that significant cognitive decline and MCI may be considered additional disease complications of diabetes among diverse middleaged and older Hispanics/Latinos.

Race/Ethnic Disparities in Mild Cognitive Impairment and Dementia: The Northern Manhattan Study

“…Among Black and Caribbean Hispanic Medicare recipients in Northern Manhattan, diabetes contributed significantly to MCI and dementia risk [ 37, 38 ]. Diabetes mellitus was also a risk factor for MCI in the Hispanic Communities Health Study that includes Caribbean Hispanic participants, such as in NOMAS, and other groups [ 39 ]. In the community-based participatory research approach-based Health and Aging Brain among Latino Elders (HABLE) study, comorbid depression and diabetes was associated with greater odds of MCI in Mexican Americans [ 40 ].…”

Race/Ethnic Disparities in Mild Cognitive Impairment and Dementia: The Northern Manhattan Study

“…35, 36 Diabetes was also a risk factor for MCI in the Hispanic Communities Health Study, which includes Caribbean Hispanic participants such as in NOMAS and other groups. 37 In NOMAS, we did not find that diabetes was a significant contributor to the odds of MCI or dementia prevalence, but continued follow-up is needed. Midlife hypertension has also been associated with MCI and dementia risk in diverse cohorts, but the risk for dementia was greater for White than Black participants in a biracial study.…”

Hearing Sensitivity, Cardiovascular Risk, and Neurocognitive Function

“…This contrasts with our recent study demonstrating that diabetes was related to significant cognitive decline and mild cognitive impairment. However, the high-CVDR group was independently associated with poorer cognition across all domains, and such relationships were not contingent on or exacerbated by hearing impairment. Both hearing impairment and high CVDR have been associated with changes in brain structure, which may compromise cognitive functioning.…”