The impact of cardiovascular risk factors on cognition in Hispanics and non-Hispanic whites

Abstract

Among non-Hispanic whites, cardiovascular risk factors are associated with increased mortality and poorer cognition. Prevalence of cardiovascular risk factors among aging Hispanics is also high and Hispanics generally have poorer access to healthcare, yet they tend to have advantageous cardiovascular disease rates and outcomes and live longer than non-Hispanic whites, an epidemiological phenomenon commonly referred to as the Hispanic or Latino health paradox. Although robust data support these ethnic benefits on physical health and mortality, it is unknown if it extends to include cognition resilience advantages in older adulthood. The present study compared relationships between cardiovascular risk and cognition (executive functions and episodic memory) in late middle age and older Hispanics (n = 87) and non-Hispanic whites (n = 81). Participants were selected from the National Alzheimer's Coordinating Center and Alzheimer's Disease Neuroimaging Initiative databases. Hispanics and non-Hispanic white groups were matched on age (50-94 yr, mean age = 72 yr), education, gender, cognitive status (i.e., cognitively healthy versus mildly cognitively impaired), and apolipoprotein E4 status. History of hypertension and higher body mass index were both associated with poorer executive functions among Hispanics but not non-Hispanic whites. Our findings suggest greater vulnerability to impairments in executive functions among Hispanics with hypertension and obesity, contrary to the notion of a Hispanic health paradox for cognitive aging.

Apolipoprotein E ε4 Allele-Based Differences in Brain Volumes Are Largely Uniform Across Late Middle Aged and Older Hispanic/Latino- and Non-Hispanic/Latino Whites Without Dementia

“…In the present study, Hispanics/Latinos and non-Hispanic/Latino Whites differed on multiple cognitive measures as was expected, given the previous cognitive comparisons of the same sample (Stickel et al, 2019). We found lower performance on the measures of working memory and one of the two processing speed measures among Hispanics/Latinos compared to non-Hispanic/Latino Whites.…”

“…The primary goal of ADNI has been to test whether serial MRI, PET, other biological markers, and clinical and neuropsychological assessment can be combined to measure the progression of MCI and early AD. 3 We have previously published the data of 168 of these participants (see Stickel et al, 2019) in a study on cardiovascular disease risk factors and cognition. The present study included a total of 178 participants without a diagnosis of dementia, who at a minimum underwent neuroimaging and genotyping for APOE.…”

“…As described by Stickel et al (2019), one memory measure was calculated across NACC and ADNI participants based on delayed recall on either a verbally presented story or a verbally presented list. Specifically, the Logical Memory Story IIA, recall (score range: 0-25), and the RAVLT (score range: 0-15) number correct raw scores were transformed to z-scores separately using the mean and SD of the corresponding NACC or ADNI sample.…”

Systolic Blood Pressure and Cognition in the Elderly: The Northern Manhattan Study1

“…Another study shows mean SBP level in Black individuals is associated with significantly faster decline in global cognition and memory but slower declines in executive function [22]. Among Hispanics, the individuals with history of hypertension are reported to be associated with poorer executive function as compared to non-Hispanic whites [23]. Taken together, the relationship between blood pressure and cognition among multi-ethnic and racial groups remains to be investigated.…”

Neuropsychiatric Symptoms by Cognitive Status for Mexican-Americans Aged 85 and Older

“…Interestingly, there has been a higher increase in the prevalence of vascular dementia than Alzheimer’s disease in Hispanic populations ( Fitten et al, 2001 ). This may be due in part to the high prevalence of hypertension and type II diabetes among older Hispanics of which are both associated with an increased risk for vascular dementia ( Bangen et al, 2015 ; Downer et al, 2016a ; Stickel et al, 2019 ).…”