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Parada H, Hyde ET, Turyk ME, Persky V, López-Gálvez N, Gallo LC, Talavera GA, Sjodin A, González HM. Persistent organic pollutants and cognitive decline among middle-aged or older adults in the Hispanic Community Health Study/Study of Latinos. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 282:116697. [PMID: 39002382 DOI: 10.1016/j.ecoenv.2024.116697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 07/03/2024] [Accepted: 07/04/2024] [Indexed: 07/15/2024]
Abstract
Persistent organic pollutants may negatively impact cognition; however, associations between persistent organic pollutants and changes in cognition among United States Hispanic/Latino adults have not been investigated. Herein, we examined the associations between 33 persistent organic pollutants and cognitive changes among 1837 Hispanic/Latino adults. At baseline (2008-2011; Visit 1), participants provided biospecimens in which we measured levels of 5 persistent pesticides or pesticide metabolites, 4 polybrominated diphenyl ethers and 2,2',4,4',5,5'-hexabromobiphenyl, and 24 polychlorinated biphenyls. At Visit 1 and again at Visit 2 (2015-2018), a battery of neurocognitive tests was administered which included the Brief-Spanish English Verbal Learning Test, Word Fluency Test, and Digit Symbol Substitution Test. To estimate the adjusted associations between changes in cognition and each POP, we used linear regression for survey data. Each doubling in plasma levels of polychlorinated biphenyls 146, 178, 194, 199/206, and 209 was associated with steeper declines in global cognition (βs range:-0.053 to -0.061) with stronger associations for the Brief-Spanish English Verbal Learning Test. Persistent organic pollutants, in particular polychlorinated biphenyls, were associated with declines in cognition over 7 years and may be a concern for Hispanic/Latino adults.
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Affiliation(s)
- Humberto Parada
- Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, CA, USA.
| | - Eric T Hyde
- Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, CA, USA; Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, San Diego, CA, USA.
| | - Mary E Turyk
- School of Public Health, University of Illinois at Chicago, Chicago, IL, USA.
| | - Victoria Persky
- School of Public Health, University of Illinois at Chicago, Chicago, IL, USA.
| | - Nicolas López-Gálvez
- Division of Health Promotion and Behavioral Science, School of Public Health, San Diego State University, San Diego, CA, USA.
| | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, CA, USA.
| | - Gregory A Talavera
- Department of Psychology, San Diego State University, San Diego, CA, USA.
| | - Andreas Sjodin
- Centers for Disease Control and Prevention (CDC), National Center for Environmental Health (NCEH), Division of Laboratory Sciences (DLS), USA.
| | - Hector M González
- Department of Neurosciences, University of California, La Jolla, San Diego, CA 92093, USA.
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2
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Smagula SF, Zhang G, Krafty RT, Ramos A, Sotres-Alvarez D, Rodakowski J, Gallo LC, Lamar M, Gujral S, Fischer D, Tarraf W, Mossavar-Rahmani Y, Redline S, Stone KL, Gonzalez HM, Patel SR. Sleep-wake behaviors associated with cognitive performance in middle-aged participants of the Hispanic Community Health Study/Study of Latinos. Sleep Health 2024; 10:500-507. [PMID: 38693044 PMCID: PMC11309910 DOI: 10.1016/j.sleh.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 01/26/2024] [Accepted: 02/20/2024] [Indexed: 05/03/2024]
Abstract
OBJECTIVES Many sleep-wake behaviors have been associated with cognition. We examined a panel of sleep-wake/activity characteristics to determine which are most robustly related to having low cognitive performance in midlife. Secondarily, we evaluate the predictive utility of sleep-wake measures to screen for low cognitive performance. METHODS The outcome was low cognitive performance defined as being >1 standard deviation below average age/sex/education internally normalized composite cognitive performance levels assessed in the Hispanic Community Health Study/Study of Latinos. Analyses included 1006 individuals who had sufficient sleep-wake measurements about 2years later (mean age=54.9, standard deviation= 5.1; 68.82% female). We evaluated associations of 31 sleep-wake variables with low cognitive performance using separate logistic regressions. RESULTS In individual models, the strongest sleep-wake correlates of low cognitive performance were measures of weaker and unstable 24-hour rhythms; greater 24-hour fragmentation; longer time-in-bed; and lower rhythm amplitude. One standard deviation worse on these sleep-wake factors was associated with ∼20%-30% greater odds of having low cognitive performance. In an internally cross-validated prediction model, the independent correlates of low cognitive performance were: lower Sleep Regularity Index scores; lower pseudo-F statistics (modellability of 24-hour rhythms); lower activity rhythm amplitude; and greater time in bed. Area under the curve was low/moderate (64%) indicating poor predictive utility. CONCLUSION The strongest sleep-wake behavioral correlates of low cognitive performance were measures of longer time-in-bed and irregular/weak rhythms. These sleep-wake assessments were not useful to identify previous low cognitive performance. Given their potential modifiability, experimental trials could test if targeting midlife time-in-bed and/or irregular rhythms influences cognition.
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Affiliation(s)
- Stephen F Smagula
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
| | - Gehui Zhang
- Department of Biostatistics, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Robert T Krafty
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Alberto Ramos
- Department of Neurology, University of Miami, Miller School of Medicine, Miami, Florida, USA
| | - Daniela Sotres-Alvarez
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Juleen Rodakowski
- Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Linda C Gallo
- Department of Psychology, University of California San Diego, San Diego, California, USA
| | - Melissa Lamar
- Institute of Minority Health Research, Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA; Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
| | - Swathi Gujral
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Dorothee Fischer
- Department of Sleep and Human Factors Research, Institute for Aerospace Medicine, German Aerospace Center, Cologne, Germany
| | - Wassim Tarraf
- Institute of Gerontology, Wayne State University, Detroit, Michigan, USA
| | - Yasmin Mossavar-Rahmani
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, New York, New York, USA
| | - Susan Redline
- Division of Sleep Medicine, Harvard Medical School, Harvard University, Boston, Massachusetts, USA
| | - Katie L Stone
- California Pacific Medical Center Research Institute, San Francisco, California, USA; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
| | - Hector M Gonzalez
- Department of Neurosciences and the Shiley-Marcos Alzheimer's Disease Research Center, UC San Diego, San Diego, California, USA
| | - Sanjay R Patel
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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González HM, Tarraf W, Stickel AM, Morlett A, González KA, Ramos AR, Rundek T, Gallo LC, Talavera GA, Daviglus ML, Lipton RB, Isasi C, Lamar M, Zeng D, DeCarli C. Glycemic Control, Cognitive Aging, and Impairment Among Diverse Hispanic/Latino Individuals: Study of Latinos- Investigation of Neurocognitive Aging (Hispanic Community Health Study/Study of Latinos). Diabetes Care 2024; 47:1152-1161. [PMID: 38684486 PMCID: PMC11208749 DOI: 10.2337/dc23-2003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 04/03/2024] [Indexed: 05/02/2024]
Abstract
OBJECTIVE Hispanic/Latino individuals in the U.S. have the highest prevalence of undiagnosed and untreated diabetes and are at increased risk for cognitive impairment. In this study, we examine glycemic control in relation to cognitive aging and impairment in a large prospective cohort of middle-aged and older Hispanic/Latino individuals of diverse heritages. RESEARCH DESIGN AND METHODS Study of Latinos-Investigation of Neurocognitive Aging (SOL-INCA) is a Hispanic Community Health Study/Study of Latinos (HCHS/SOL) ancillary study. HCHS/SOL is a multisite (Bronx, NY; Chicago, IL; Miami, FL; and San Diego, CA), probability sampled prospective cohort study. SOL-INCA enrolled 6,377 diverse Hispanic/Latino individuals aged 50 years and older (2016-2018). The primary outcomes were cognitive function, 7-year cognitive decline, and mild cognitive impairment (MCI). The primary glycemia exposure variables were measured from fasting blood samples collected at HCHS/SOL visit 1 (2008-2011). RESULTS Visit 1 mean age was 56.5 years ± 8.2 SD, and the average glycosylated hemoglobin A1C (HbA1c) was 6.12% (43.5 ± 14.6 mmol/mol). After covariate adjustment, higher HbA1c was associated with accelerated 7-year global (b = -0.045; 95% CI -0.070; -0.021; in z score units) and executive cognitive decline and a higher prevalence of MCI (odds ratio 1.20; 95% CI 1.11; 1.29). CONCLUSIONS Elevated HbA1c levels were associated with 7-year executive cognitive decline and increased MCI risk among diverse middle-aged and older Hispanic/Latino individuals. Our findings indicate that poor glycemic control in midlife may pose significant risks for cognitive decline and MCI later in life among Hispanic/Latino individuals of diverse heritages.
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Affiliation(s)
- Hector M. González
- Department of Neurosciences and the Shiley-Marcos Alzheimer’s Disease Research Center, University of California San Diego, San Diego, CA
| | - Wassim Tarraf
- Institute of Gerontology & Department of Healthcare Sciences, Wayne State University, Detroit, MI
| | | | - Alejandra Morlett
- Department of Neurosciences and the Shiley-Marcos Alzheimer’s Disease Research Center, University of California San Diego, San Diego, CA
| | - Kevin A. González
- Department of Neurosciences and the Shiley-Marcos Alzheimer’s Disease Research Center, University of California San Diego, San Diego, CA
| | - Alberto R. Ramos
- Department of Neurology and Evelyn F. McKnight Brain Institute, University of Miami, Miami, FL
| | - Tatjana Rundek
- Department of Neurology and Evelyn F. McKnight Brain Institute, University of Miami, Miami, FL
| | - Linda C. Gallo
- Department of Psychology, San Diego State University, San Diego, CA
| | | | - Martha L. Daviglus
- Institute for Minority Health Research, University of Illinois College of Medicine at Chicago, Chicago, IL
| | | | - Carmen Isasi
- Albert Einstein College of Medicine, New York, NY
| | - Melissa Lamar
- Institute for Minority Health Research, University of Illinois College of Medicine at Chicago, Chicago, IL
- Department of Psychiatry & Behavioral Sciences and Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL
| | - Donglin Zeng
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
| | - Charles DeCarli
- Department of Neurology and Alzheimer’s Disease Center, University of California Davis, Sacramento, CA
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Palacios N, Gordon S, Wang T, Burk R, Qi Q, Huttenhower C, Gonzalez HM, Knight R, De Carli C, Daviglus M, Lamar M, Telavera G, Tarraf W, Kosciolek T, Cai J, Kaplan RC. Gut Microbiome Multi-Omics and Cognitive Function in the Hispanic Community Health Study/Study of Latinos- Investigation of Neurocognitive Aging. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.05.17.24307533. [PMID: 38798527 PMCID: PMC11118626 DOI: 10.1101/2024.05.17.24307533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
INTRODUCTION We conducted a study within the Hispanic Community Health Study/Study of Latinos- Investigation of Neurocognitive Aging (HCHS/SOL-INCA) cohort to examine the association between gut microbiome and cognitive function. METHODS We analyzed the fecal metagenomes of 2,471 HCHS/SOL-INCA participants to, cross-sectionally, identify microbial taxonomic and functional features associated with global cognitive function. Omnibus (PERMANOVA) and feature-wise analyses (MaAsLin2) were conducted to identify microbiome-cognition associations, and specific microbial species and pathways (Kyoto Encyclopedia of Genes and Genomes (KEGG modules) associated with cognition. RESULTS Eubacterium species( E. siraeum and E. eligens ), were associated with better cognition. Several KEGG modules, most strongly Ornithine, Serine biosynthesis and Urea Cycle, were associated with worse cognition. DISCUSSION In a large Hispanic/Latino cohort, we identified several microbial taxa and KEGG pathways associated with cognition.
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Stickel AM, Mendoza A, Tarraf W, Kuwayama S, Kaur S, Morlett Paredes A, Daviglus ML, Testai FD, Zeng D, Isasi CR, Baiduc RR, Dinces E, Lee DJ, González HM. Hearing Loss and Associated 7-Year Cognitive Outcomes Among Hispanic and Latino Adults. JAMA Otolaryngol Head Neck Surg 2024; 150:385-392. [PMID: 38512278 PMCID: PMC10958383 DOI: 10.1001/jamaoto.2024.0184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 01/29/2024] [Indexed: 03/22/2024]
Abstract
Importance Hearing loss appears to have adverse effects on cognition and increases risk for cognitive impairment. These associations have not been thoroughly investigated in the Hispanic and Latino population, which faces hearing health disparities. Objective To examine associations between hearing loss with 7-year cognitive change and mild cognitive impairment (MCI) prevalence among a diverse cohort of Hispanic/Latino adults. Design, Setting, and Participants This cohort study used data from a large community health survey of Hispanic Latino adults in 4 major US cities. Eligible participants were aged 50 years or older at their second visit to study field centers. Cognitive data were collected at visit 1 and visit 2, an average of 7 years later. Data were last analyzed between September 2023 and January 2024. Exposure Hearing loss at visit 1 was defined as a pure-tone average (500, 1000, 2000, and 4000 Hz) greater than 25 dB hearing loss in the better ear. Main outcomes and measures Cognitive data were collected at visit 1 and visit 2, an average of 7 years later and included measures of episodic learning and memory (the Brief-Spanish English Verbal Learning Test Sum of Trials and Delayed Recall), verbal fluency (word fluency-phonemic fluency), executive functioning (Trails Making Test-Trail B), and processing speed (Digit-Symbol Substitution, Trails Making Test-Trail A). MCI at visit 2 was defined using the National Institute on Aging-Alzheimer Association criteria. Results A total of 6113 Hispanic Latino adults were included (mean [SD] age, 56.4 [8.1] years; 3919 women [64.1%]). Hearing loss at visit 1 was associated with worse cognitive performance at 7-year follow-up (global cognition: β = -0.11 [95% CI, -0.18 to -0.05]), equivalent to 4.6 years of aging and greater adverse change (slowing) in processing speed (β = -0.12 [95% CI, -0.23 to -0.003]) equivalent to 5.4 years of cognitive change due to aging. There were no associations with MCI. Conclusions and relevance The findings of this cohort study suggest that hearing loss decreases cognitive performance and increases rate of adverse change in processing speed. These findings underscore the need to prevent, assess, and treat hearing loss in the Hispanic and Latino community.
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Affiliation(s)
- Ariana M. Stickel
- Department of Psychology, San Diego State University, San Diego, California
| | - Alonzo Mendoza
- Department of Neurosciences, University of California, San Diego, La Jolla
| | - Wassim Tarraf
- Institute of Gerontology & Department of Healthcare Sciences, Wayne State University, Detroit, Michigan
| | - Sayaka Kuwayama
- Department of Neurosciences, University of California, San Diego, La Jolla
| | - Sonya Kaur
- Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida
| | | | - Martha L. Daviglus
- Institute for Minority Health Research, College of Medicine, University of Illinois at Chicago, Chicago
| | - Fernando D. Testai
- Department of Neurology & Rehabilitation, College of Medicine, University of Illinois at Chicago, Chicago
| | - Donglin Zeng
- Department of Biostatistics, University of North Carolina, Chapel Hill
| | - Carmen R. Isasi
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Rachael R. Baiduc
- Speech, Language, and Hearing Sciences, University of Colorado Boulder, Boulder
| | - Elizabeth Dinces
- Department of Otorhinolaryngology, Albert Einstein College of Medicine, Bronx, New York
| | - David J. Lee
- Department of Epidemiology & Public Health, University of Miami, Miami, Florida
| | - Hector M. González
- Department of Neurosciences, University of California, San Diego, La Jolla
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Estrella ML, Tarraf W, Kuwayama S, Gallo LC, Wu B, Marquine MJ, Perreira KM, Vasquez PM, Isasi CR, Lipton RB, Mattei J, González HM, Daviglus ML, Lamar M. Psychosocial factors associated with 7-year change in cognition among middle-aged and older Hispanics/Latinos: The Hispanic Community Health Study/Study of Latinos-Investigation of Neurocognitive Aging (SOL-INCA) and Sociocultural ancillary studies. Alzheimers Dement 2024; 20:1137-1148. [PMID: 37897802 PMCID: PMC10916974 DOI: 10.1002/alz.13527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 08/02/2023] [Accepted: 10/06/2023] [Indexed: 10/30/2023]
Abstract
INTRODUCTION Few studies have examined the associations of psychosocial factors with cognitive change in Hispanics/Latinos. METHODS Data from the Hispanic Community Health Study/Study of Latinos-Investigation of Neurocognitive Aging (HCHS/SOL INCA) and Sociocultural studies were used (n = 2,155; ages ≥45 years). Psychosocial exposures included intrapersonal (ethnic identity, optimism, purpose in life), interpersonal (family cohesion, familism, social networks, social support), and social factors (ethnic discrimination, loneliness, subjective social status). Survey-linear regression models examined associations between psychosocial exposures and 7-year cognitive change (global cognition [GC], verbal learning, memory, word fluency [WF], and digit symbol substitution [DSS]). RESULTS Familism predicted decline in GC, verbal learning, and memory; family cohesion predicted DSS decline; and loneliness predicted memory decline. Ethnic identity was protective against decline in GC and memory, optimism and social support were protective against decline in memory, and purpose in life was protective against WF decline. DISCUSSION Psychosocial factors are differentially related to cognitive changes. Culturally relevant factors should be explored in Hispanic/Latino cognitive aging research. HIGHLIGHTS Psychosocial factors are differentially related to cognitive changes in Latinos. Role of culturally relevant factors on cognition should be further explored. Familism predicted decline in global cognition, verbal learning, and memory. Ethnic identity predicted increase in global cognition and memory.
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Affiliation(s)
- Mayra L. Estrella
- Department of EpidemiologyHuman Genetics and Environmental SciencesUniversity of Texas Health Sciences Center at Houston (UTHealth Houston) School of Public HealthBrownsvilleTexasUSA
- Institute for Minority Health ResearchUniversity of Illinois at ChicagoChicagoIllinoisUSA
| | - Wassim Tarraf
- Institute of Gerontology and Department of Healthcare SciencesWayne State UniversityDetroitMichiganUSA
| | - Sayaka Kuwayama
- Department of Neurosciences and Shiley‐Marcos Alzheimer's Disease Research CenterUniversity of CaliforniaSan DiegoCaliforniaUSA
| | - Linda C. Gallo
- Department of PsychologySan Diego State UniversitySan DiegoCaliforniaUSA
| | - Benson Wu
- Department of Neurosciences and Shiley‐Marcos Alzheimer's Disease Research CenterUniversity of CaliforniaSan DiegoCaliforniaUSA
| | - María J. Marquine
- Departments of Medicine and PsychiatryDuke Center for the Study of Aging and Human DevelopmentDuke UniversityDurhamNorth CarolinaUSA
| | - Krista M. Perreira
- Department of Social MedicineUniversity of North Carolina School of MedicineChapel HillNorth CarolinaUSA
| | - Priscilla M. Vasquez
- Department of Urban Public HealthCharles R. Drew University of Medicine and ScienceLos AngelesCaliforniaUSA
| | - Carmen R. Isasi
- Department of Epidemiology and Population HealthAlbert Einstein College of MedicineBronxNew YorkUSA
| | - Richard B. Lipton
- Department of NeurologyAlbert Einstein College of MedicineNew YorkNew YorkUSA
| | - Josiemer Mattei
- Department of NutritionHarvard T.H. Chan School of Public HealthBostonMassachusettsUSA
| | - Hector M. González
- Department of Neurosciences and Shiley‐Marcos Alzheimer's Disease Research CenterUniversity of CaliforniaSan DiegoCaliforniaUSA
| | - Martha L. Daviglus
- Institute for Minority Health ResearchUniversity of Illinois at ChicagoChicagoIllinoisUSA
| | - Melissa Lamar
- Institute for Minority Health ResearchUniversity of Illinois at ChicagoChicagoIllinoisUSA
- Rush Alzheimer's Disease Center and the Department of Psychiatry and Behavioral SciencesRush University Medical CenterChicagoIllinoisUSA
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7
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Estrella ML, Tarraf W, Kuwayama S, Gallo LC, Salazar CR, Stickel AM, Mattei J, Vásquez PM, Eldeirawi KM, Perreira KM, Penedo FJ, Isasi CR, Cai J, Zeng D, González HM, Daviglus ML, Lamar M. Associations of Allostatic Load with Level of and Change in Cognitive Function Among Middle-Aged and Older Hispanic/Latino Adults: The Study of Latinos-Investigation of Neurocognitive Aging (SOL-INCA). J Alzheimers Dis 2024; 99:1047-1064. [PMID: 38758999 PMCID: PMC11343490 DOI: 10.3233/jad-230796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2024]
Abstract
Background Higher allostatic load (AL), a multi-system measure of physiological dysregulation considered a proxy for chronic stress exposure, is associated with poorer global cognition (GC) in older non-Hispanic white adults. However, evidence of these associations in middle-aged and older US-based Hispanic/Latino adults is limited. Objective To examine associations of AL with level of cognition, performance in cognition 7 years later, and change in cognition over 7 years among middle-aged and older US-based Hispanic/Latino adults. Methods We used data (n = 5,799, 45-74 years at baseline) from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) and SOL-Investigation of Neurocognitive Aging (SOL-INCA). The AL score comprised 16 biomarkers representing cardiometabolic, glucose, cardiopulmonary, parasympathetic, and inflammatory systems (higher scores = greater dysregulation). Cognitive outcomes included GC and individual tests of verbal learning and memory, world fluency (WF), Digit Symbol Substitution (DSS), and Trail Making (Parts A & B). Survey-linear regressions assessed associations of AL with performance in cognition at baseline, 7 years later, and via 7-year cognitive change scores adjusting for sociodemographic characteristics, lifestyle factors, and depressive symptoms. Results Higher AL was associated with lower baseline performance in GC and WF; and lower 7-year follow-up performance in these same measures plus DSS and Trail Making Parts A & B. Higher AL was associated with more pronounced 7-year change (reduction) in GC and on WF and DSS tests. Conclusions Findings extend previous evidence in predominantly older non-Hispanic white cohorts to show that AL is related to level of and change in GC (as well as WF and DSS) among middle-aged and older US-based Hispanic/Latino adults.
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Affiliation(s)
- Mayra L. Estrella
- Rush Alzheimer’s Disease Center and the Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL, USA
| | - Wassim Tarraf
- Institute of Gerontology and Department of Healthcare Sciences, Wayne State University, Detroit, MI, USA
| | - Sayaka Kuwayama
- Department of Neurosciences and Shiley-Marcos Alzheimer’s Disease Research Center, University of California, San Diego, San Diego, CA, USA
| | - Linda C. Gallo
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Christian R. Salazar
- University of California Irvine Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, USA
| | - Ariana M. Stickel
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Josiemer Mattei
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Priscilla M. Vásquez
- Department of Urban Public Health, Charles R. Drew University of Science and Medicine, Los Angeles, CA, USA
| | - Kamal M. Eldeirawi
- Department of Population Health Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL, USA
| | - Krista M. Perreira
- Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Frank J. Penedo
- Department of Psychology and Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA
| | - Carmen R. Isasi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Jianwen Cai
- Department of Biostatistics, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Donglin Zeng
- Department of Biostatistics, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Hector M. González
- Department of Neurosciences and Shiley-Marcos Alzheimer’s Disease Research Center, University of California, San Diego, CA, USA
| | - Martha L. Daviglus
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL, USA
| | - Melissa Lamar
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL, USA
- Rush Alzheimer’s Disease Center and the Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
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8
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Márquez F, Tarraf W, Stickel AM, González KA, Testai FD, Cai J, Gallo LC, Talavera GA, Daviglus ML, Wassertheil-Smoller S, DeCarli C, Schneiderman N, González HM. Hypertension, Cognitive Decline, and Mild Cognitive Impairment Among Diverse Hispanics/Latinos: Study of Latinos-Investigation of Neurocognitive Aging Results (SOL-INCA). J Alzheimers Dis 2024; 97:1449-1461. [PMID: 38250769 DOI: 10.3233/jad-230424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
BACKGROUND Hypertension can have deleterious effects on cognitive function; however, few studies have examined its effects on cognition among Hispanics/Latinos. OBJECTIVE To assess associations between hypertension status with 1) change in cognitive performance, and 2) having mild cognitive impairment (MCI) among diverse Hispanics/Latinos. METHODS This population-based, prospective cohort, multisite study included Hispanic/Latino adults aged 45 to 72 years in enrolled in the Hispanic Community Health Study/Study of Latinos at Visit 1 (2008-2011; mean age of 63.40±8.24 years), and the Study of Latinos-Investigation of Neurocognitive Aging at Visit 2 (2016-2018), with a mean follow-up duration of 7 years (n = 6,173). Hypertension status was assessed at both visits: normotension (no hypertension), incident hypertension (only at Visit 2), and persistent hypertension (at both visits). We examined change in cognitive performance and having MCI (only assessed at Visit 2) relative to hypertension status and adjusted for demographics and cardiovascular disease risk factors. RESULTS Compared to normotension, persistent hypertension was associated with significantly increased decline in verbal fluency (β= -0.08; CI = [-0.16;-0.01]; p < 0.05), and processing speed (β= -0.11; CI = [-0.20;-0.02]; p < 0.05). Incident hypertension was not associated with significant change in cognitive performance. Both incident (OR = 1.70; CI = [1.16;2.50]; p < 0.01) and persistent hypertension (OR = 2.13; CI = [1.57;2.88]; p < 0.001) were associated with significantly higher odds ratios of having MCI. CONCLUSIONS These findings indicate that persistent hypertension is associated with clinical impairment and domain-specific cognitive decline in middle-aged and older Hispanics/Latinos. It underscores the importance of monitoring blood pressure in routine healthcare visits beginning at midlife in this population to reduce the burden of cognitive decline.
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Affiliation(s)
- Freddie Márquez
- Department of Neurosciences and the Shiley-Marcos Alzheimer's Disease Research Center, UC San Diego, San Diego, CA, USA
| | - Wassim Tarraf
- Institute of Gerontology & Department of Healthcare Sciences, Wayne State University, Detroit, MI, USA
| | - Ariana M Stickel
- Department of Neurosciences and the Shiley-Marcos Alzheimer's Disease Research Center, UC San Diego, San Diego, CA, USA
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Kevin A González
- Department of Neurosciences and the Shiley-Marcos Alzheimer's Disease Research Center, UC San Diego, San Diego, CA, USA
| | - Fernando D Testai
- Department of Neurology and Rehabilitation, University of Illinois at Chicago, College of Medicine, Chicago, IL, USA
| | - Jianwen Cai
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Gregory A Talavera
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Martha L Daviglus
- Institute for Minority Health Research, University of Illinois at Chicago, College of Medicine, Chicago, IL, USA
| | - Sylvia Wassertheil-Smoller
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, New York, NY, USA
| | - Charles DeCarli
- Department of Neurology and Alzheimer's Disease Center, UC Davis, Sacramento, CA, USA
| | | | - Hector M González
- Department of Neurosciences and the Shiley-Marcos Alzheimer's Disease Research Center, UC San Diego, San Diego, CA, USA
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González KA, Tarraf W, Stickel AM, Kaur S, Agudelo C, Redline S, Gallo LC, Isasi CR, Cai J, Daviglus ML, Testai FD, DeCarli C, González HM, Ramos AR. Sleep duration and brain MRI measures: Results from the SOL-INCA MRI study. Alzheimers Dement 2024; 20:641-651. [PMID: 37772658 PMCID: PMC10840814 DOI: 10.1002/alz.13451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 08/08/2023] [Accepted: 08/09/2023] [Indexed: 09/30/2023]
Abstract
INTRODUCTION Sleep duration has been associated with dementia and stroke. Few studies have evaluated sleep pattern-related outcomes of brain disease in diverse Hispanics/Latinos. METHODS The SOL-INCA (Study of Latinos-Investigation of Neurocognitive Aging) magnetic resonance imaging (MRI) study recruited diverse Hispanics/Latinos (35-85 years) who underwent neuroimaging. The main exposure was self-reported sleep duration. Our main outcomes were total and regional brain volumes. RESULTS The final analytic sample included n = 2334 participants. Increased sleep was associated with smaller brain volume (βtotal_brain = -0.05, p < 0.01) and consistently so in the 50+ subpopulation even after adjusting for mild cognitive impairment status. Sleeping >9 hours was associated with smaller gray (βcombined_gray = -0.17, p < 0.05) and occipital matter volumes (βoccipital_gray = -0.18, p < 0.05). DISCUSSION We found that longer sleep duration was associated with lower total brain and gray matter volume among diverse Hispanics/Latinos across sex and background. These results reinforce the importance of sleep on brain aging in this understudied population. HIGHLIGHTS Longer sleep was linked to smaller total brain and gray matter volumes. Longer sleep duration was linked to larger white matter hyperintensities (WMHs) and smaller hippocampal volume in an obstructive sleep apnea (OSA) risk group. These associations were consistent across sex and Hispanic/Latino heritage groups.
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Affiliation(s)
- Kevin A. González
- Department of Neurosciences and Shiley‐Marcos Alzheimer's Disease Research CenterUniversity of California San Diego School of MedicineSan DiegoCaliforniaUSA
| | - Wassim Tarraf
- Department of Healthcare Sciences and Institute of GerontologyWayne State UniversityDetroitMichiganUSA
| | - Ariana M. Stickel
- Department of PsychologySan Diego State UniversitySan DiegoCaliforniaUSA
| | - Sonya Kaur
- Department of NeurologyUniversity of Miami Miller School of MedicineMiamiFloridaUSA
| | - Christian Agudelo
- Department of NeurologyUniversity of Miami Miller School of MedicineMiamiFloridaUSA
| | - Susan Redline
- Department of MedicineBrigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Linda C. Gallo
- Department of Psychology and South Bay Latino Research CenterSan Diego State UniversitySan DiegoCaliforniaUSA
| | - Carmen R. Isasi
- Department of Epidemiology & Population HealthAlbert Einstein College of MedicineBronxNew YorkUSA
| | - Jianwen Cai
- Department of BiostatisticsUniversity of North CarolinaChapel HillNorth CarolinaUSA
| | - Martha L. Daviglus
- Institute for Minority Health ResearchCollege of MedicineUniversity of Illinois at ChicagoChicagoIllinoisUSA
| | - Fernando D. Testai
- Department of Neurology and RehabilitationUniversity of Illinois College of MedicineChicagoIllinoisUSA
| | - Charles DeCarli
- Department of NeurologyUniversity of California DavisSacramentoCaliforniaUSA
| | - Hector M. González
- Department of Neurosciences and Shiley‐Marcos Alzheimer's Disease Research CenterUniversity of California San Diego School of MedicineSan DiegoCaliforniaUSA
| | - Alberto R. Ramos
- Department of NeurologyUniversity of Miami Miller School of MedicineMiamiFloridaUSA
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Filigrana P, Moon JY, Gallo LC, Fernández-Rhodes L, Perreira KM, Daviglus ML, Thyagarajan B, Garcia-Bedoya OL, Cai J, Lipton RB, Kaplan RC, Gonzalez HM, Isasi CR. Childhood and Life-Course Socioeconomic Position and Cognitive Function in the Adult Population of the Hispanic Community Health Study/Study of Latinos. Am J Epidemiol 2023; 192:2006-2017. [PMID: 37420108 PMCID: PMC10988221 DOI: 10.1093/aje/kwad157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 07/03/2023] [Accepted: 07/04/2023] [Indexed: 07/09/2023] Open
Abstract
The Hispanic/Latino population experiences socioeconomic adversities across the lifespan and is at greater risk of cognitive impairment, yet little is known about the role of life-course socioeconomic position (SEP) in cognitive function in this population. Using baseline data (2008-2011) from adults (aged 45-74 years) of the Hispanic Community Health Study/Study of Latinos, we assessed the association between childhood SEP and socioeconomic mobility with cognitive function, and whether this association was mediated by midlife SEP. Childhood SEP was assessed using parental education. An index combining participants' education and household income represented midlife SEP. Socioeconomic mobility was categorized as stable low, downward or upward mobility, and stable high-SEP. Cognitive function measures were modeled using survey linear regression with inverse-probability weighting, accounting for covariates. We used mediation analysis to estimate the indirect effect of childhood SEP on cognition through midlife SEP. High childhood SEP was associated with global cognition in adulthood (coefficient for parental education beyond high school vs. less than high school = 0.26, 95% confidence interval: 0.15, 0.37). This association was partially mediated through midlife SEP (indirect effect coefficient = 0.16, 95% confidence interval: 0.15, 0.18). Low SEP through the life course was associated with the lowest cognitive function. This study provides evidence that life-course SEP influences cognitive performance in adulthood.
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Affiliation(s)
- Paola Filigrana
- Correspondence to Dr. Paola Filigrana, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Belfer Building-Room 1308, Bronx, NY 10461 (e-mail: )
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11
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Gadde KM, Yin X, Goldberg RB, Orchard TJ, Schlögl M, Dabelea D, Ibebuogu UN, Watson KE, Pi‐Sunyer FX, Crandall JP, Temprosa M, Luchsinger JA. Coronary Artery Calcium and Cognitive Decline in the Diabetes Prevention Program Outcomes Study. J Am Heart Assoc 2023; 12:e029671. [PMID: 37929764 PMCID: PMC10727391 DOI: 10.1161/jaha.123.029671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 09/26/2023] [Indexed: 11/07/2023]
Abstract
Background Our aim was to investigate the association of coronary artery calcium (CAC) with cognitive function in adults with impaired glucose tolerance or type 2 diabetes. Methods and Results The Diabetes Prevention Program was a randomized controlled trial comparing an intensive lifestyle intervention, metformin, or placebo for prevention of type 2 diabetes among patients with prediabetes. After 3 years, intensive lifestyle intervention and placebo were stopped, the metformin arm was unmasked, and participants continued in the DPPOS (Diabetes Prevention Program Outcomes Study). Approximately 14 years after randomization (Y14), CAC (Agatston score) was assessed with computed tomography, and cognitive performance was assessed with the Spanish English Verbal Learning Test (SEVLT) and Digit Symbol Substitution Test. SEVLT and Digit Symbol Substitution Test were reassessed 5 years later (Y19) along with the Modified Mini-Mental State Exam. We examined cross-sectional and longitudinal associations between CAC and cognition among 1931 participants using linear and logistic regression. In unadjusted analyses, compared with no calcification, CAC score >300 was associated with decreased performance on all cognitive tests at Y14 in both sexes. Additionally, CAC >300 was associated with a greater 5-year decline in SEVLT Immediate Recall in both sexes and SEVLT Delayed Recall in women. After adjustment for demographic, genetic, metabolic, vascular, and behavioral covariates, CAC score >300 remained associated with greater decline in only SEVLT Delayed Recall in women. Conclusions In women with prediabetes or diabetes, CAC >300, compared with no calcification, was independently associated with greater decline in verbal memory. Registration information clinicaltrials.gov. Identifier: NCT00038727.
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Affiliation(s)
- Kishore M. Gadde
- Department of SurgeryUniversity of California, Irvine (UCI) Medical CenterOrangeCA
| | - Xiaoyan Yin
- Department of Biostatistics and BioinformaticsGeorge Washington University Biostatistics CenterRockvilleMD
| | - Ronald B. Goldberg
- Diabetes Research Institute, University of Miami Miller School of MedicineMiamiFL
| | | | - Mathias Schlögl
- Division of Geriatric Medicine, Clinic BarmelweidBarmelweidSwitzerland
| | - Dana Dabelea
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) CenterUniversity of Colorado Anschutz Medical CampusAuroraCO
| | - Uzoma N. Ibebuogu
- Department of MedicineUniversity of Tennessee Health Science CenterMemphisTN
| | - Karol E. Watson
- Department of Medicine, David Geffen School of Medicine at UCLALos AngelesCA
| | | | - Jill P. Crandall
- Department of Medicine, Albert Einstein College of MedicineBronxNY
| | - Marinella Temprosa
- Department of Biostatistics and BioinformaticsGeorge Washington University Biostatistics CenterRockvilleMD
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Grasso SM, Clark AL, Petersen M, O'Bryant S. Bilingual neurocognitive resiliency, vulnerability, and Alzheimer's disease biomarker correlates in Latino older adults enrolled in the Health and Aging Brain Study - Health Disparities (HABS-HD). ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2023; 15:e12509. [PMID: 38089652 PMCID: PMC10711150 DOI: 10.1002/dad2.12509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 09/03/2023] [Accepted: 10/27/2023] [Indexed: 02/01/2024]
Abstract
INTRODUCTION The effects of bilingualism on neuropsychological test performance in bilinguals with and without cognitive impairment are not well-understood and are relatively limited by small sample sizes of Latinos. METHODS Using analysis of covariance (ANCOVA), we explored patterns of cognitive performance and impairment across a large sample of community-dwelling bilingual and monolingual Latino older adults with (n = 180) and without (n = 643) mild cognitive impairment (MCI) enrolled in HABS-HD. RESULTS Bilinguals demonstrated cognitive resiliency in the form of significantly better performance on the Trail Making Test and Digit Symbol Substitution Test, observed across the cognitively unimpaired and MCI groups. In contrast, bilinguals demonstrated cognitive vulnerability in the form of significantly poorer performance and higher impairment rates on phonemic fluency in the MCI phase, only. Follow-up analyses revealed less balanced bilinguals demonstrated poorer performance and higher impairment rates on this measure, supported by lower levels of plasma Aβ 42/40. DISCUSSION Patterns of cognitive performance and impairment differ as a function of bilingualism. Bilingualism must be considered when evaluating cognitive and biomarker outcomes in Latino older adults. Highlights Latino bilinguals perform better on measures of processing speed and coding.Latino bilinguals with MCI demonstrate cognitive vulnerability in verbal fluency.Less balanced bilinguals demonstrate greatest vulnerability anchored by Aβ 42/40.
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Affiliation(s)
- Stephanie M Grasso
- Department of Speech, Language, & Hearing Sciences Moody College of Communication The University of Texas (UT) at Austin Austin Texas USA
| | - Alexandra L Clark
- Department of Psychology College of Liberal Arts UT Austin Austin Texas USA
| | - Melissa Petersen
- Institute for Translational Research University of North Texas Health Science Center Fort Worth Texas USA
- Department of Family Medicine University of North Texas Health Science Center Fort Worth Texas USA
| | - Sid O'Bryant
- Institute for Translational Research University of North Texas Health Science Center Fort Worth Texas USA
- Department of Family Medicine University of North Texas Health Science Center Fort Worth Texas USA
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13
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Sofer T, Kurniansyah N, Granot-Hershkovitz E, Goodman MO, Tarraf W, Broce I, Lipton RB, Daviglus M, Lamar M, Wassertheil-Smoller S, Cai J, DeCarli CS, Gonzalez HM, Fornage M. A polygenic risk score for Alzheimer's disease constructed using APOE-region variants has stronger association than APOE alleles with mild cognitive impairment in Hispanic/Latino adults in the U.S. Alzheimers Res Ther 2023; 15:146. [PMID: 37649099 PMCID: PMC10469805 DOI: 10.1186/s13195-023-01298-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 08/24/2023] [Indexed: 09/01/2023]
Abstract
INTRODUCTION Polygenic Risk Scores (PRSs) are summaries of genetic risk alleles for an outcome. METHODS We used summary statistics from five GWASs of AD to construct PRSs in 4,189 diverse Hispanics/Latinos (mean age 63 years) from the Study of Latinos-Investigation of Neurocognitive Aging (SOL-INCA). We assessed the PRS associations with MCI in the combined set of people and in diverse subgroups, and when including and excluding the APOE gene region. We also assessed PRS associations with MCI in an independent dataset from the Mass General Brigham Biobank. RESULTS A simple sum of 5 PRSs ("PRSsum"), each constructed based on a different AD GWAS, was associated with MCI (OR = 1.28, 95% CI [1.14, 1.41]) in a model adjusted for counts of the APOE-[Formula: see text] and APOE-[Formula: see text] alleles. Associations of single-GWAS PRSs were weaker. When removing SNPs from the APOE region from the PRSs, the association of PRSsum with MCI was weaker (OR = 1.17, 95% CI [1.04,1.31] with adjustment for APOE alleles). In all association analyses, APOE-[Formula: see text] and APOE-[Formula: see text] alleles were not associated with MCI. DISCUSSION A sum of AD PRSs is associated with MCI in Hispanic/Latino older adults. Despite no association of APOE-[Formula: see text] and APOE-[Formula: see text] alleles with MCI, the association of the AD PRS with MCI is stronger when including the APOE region. Thus, APOE variants different than the classic APOE alleles may be important predictors of MCI in Hispanic/Latino adults.
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Affiliation(s)
- Tamar Sofer
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA.
- Department of Medicine, Harvard Medical School, Boston, MA, USA.
- CardioVascular Institute, Beth Israel Deaconess Medical Center, Boston, MA, USA.
| | - Nuzulul Kurniansyah
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA
| | - Einat Granot-Hershkovitz
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Matthew O Goodman
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Wassim Tarraf
- Institute of Gerontology, Wayne State University, Detroit, MI, USA
| | - Iris Broce
- Department of Neurosciences, University of California San Diego, San Diego, CA, USA
| | | | - Martha Daviglus
- Department of Medicine, Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL, USA
| | - Melissa Lamar
- Department of Medicine, Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL, USA
- Rush Alzheimer's Disease Research Center, Rush University Medical Center, Chicago, IL, USA
| | - Sylvia Wassertheil-Smoller
- Department of Epidemiology & Population Health, Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Jianwen Cai
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Charles S DeCarli
- Department of Neurology, University of California at Davis, Sacramento, CA, USA
| | - Hector M Gonzalez
- Department of Neurosciences, University of California San Diego, San Diego, CA, USA
- Shiley-Marcos Alzheimer's Disease Center, University of California San Diego, La Jolla, CA, USA
| | - Myriam Fornage
- Institute of Molecular Medicine, The University of Texas Health Science Center at Houston, Houston, TX, USA
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Luchsinger JA, Kazemi EJ, Sanchez DL, Larkin ME, Valencia WM, Desouza C, Carlson AL, Pop-Busui R, Seaquist ER, Florez HJ, Barzilay J. BMI, insulin sensitivity, and cognition in early type 2 diabetes: The Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study. Obesity (Silver Spring) 2023; 31:1812-1824. [PMID: 37368512 PMCID: PMC11103776 DOI: 10.1002/oby.23785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 01/31/2023] [Accepted: 02/24/2023] [Indexed: 06/29/2023]
Abstract
OBJECTIVE This study explored the association of BMI and insulin sensitivity with cognitive performance in type 2 diabetes. METHODS A cross-sectional analysis of data from the baseline assessment of the Glycemia Reduction Approaches in Diabetes: a Comparative Effectiveness Study (GRADE) was conducted. BMI was used as a surrogate of adiposity and the Matsuda index as the measure of insulin sensitivity. Cognitive tests included the Spanish English Verbal Learning Test, the Digit Symbol Substitution Test, and the letter and animal fluency tests. RESULTS Cognitive assessments were completed by 5018 (99.4%) of 5047 participants aged 56.7 ± 10.0 years, of whom 36.4% were female. Higher BMI and lower insulin sensitivity were related to better performance on memory and verbal fluency tests. In models including BMI and insulin sensitivity simultaneously, only higher BMI was related to better cognitive performance. CONCLUSIONS In this study, higher BMI and lower insulin sensitivity in type 2 diabetes were cross-sectionally associated with better cognitive performance. However, only higher BMI was related to cognitive performance when both BMI and insulin sensitivity were considered simultaneously. The causality and mechanisms for this association need to be determined in future studies.
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Affiliation(s)
- José A. Luchsinger
- Departments of Medicine and Epidemiology, Columbia University Irving Medical Center, New York, New York, USA
| | - Erin J. Kazemi
- The Biostatistics Center, Department of Biostatistics and Bioinformatics, Milken Institute of Public Health, The George Washington University, Rockville, Maryland, USA
| | - Danurys L. Sanchez
- Department of Neurology, Gertrude H. Hergievsky Center, Columbia University Irving Medical Center, New York, New York, USA
| | - Mary E. Larkin
- Massachusetts General Hospital Diabetes Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Willy Marcos Valencia
- Department of Medicine, University of Miami, Miami, Florida, USA
- Geriatric Research Education and Clinical Center, Miami VA Healthcare System, Miami, Florida, USA
- Department of Humanities, Health and Society, Florida International University, Miami, Florida, USA
| | - Cyrus Desouza
- Omaha VA Medical Center and University of Nebraska Medical Center, Omaha, Nebraska, USA
| | | | - Rodica Pop-Busui
- Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Hermes J. Florez
- Department of Medicine, University of Miami, Miami, Florida, USA
- Geriatric Research Education and Clinical Center, Miami VA Healthcare System, Miami, Florida, USA
- Medical College of South Carolina, Charleston, South Carolina, USA
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Parada H, Pichardo MS, Gallo LC, Talavera GA, McDaniels‐Davidson C, Penedo FJ, Lee DJ, Tarraf W, Garcia TP, Daviglus ML, González HM. Neurocognitive test performance following cancer among middle-aged and older adults in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) and the SOL-Investigation of Neurocognitive Aging Ancillary Study. Cancer Med 2023; 12:11860-11870. [PMID: 36999972 PMCID: PMC10242865 DOI: 10.1002/cam4.5863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 02/20/2023] [Accepted: 03/16/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND Cancer patients and survivors often experience acute cognitive impairments; however, the long-term cognitive impact remains unclear particularly among Hispanics/Latinos. We examined the association between cancer history and neurocognitive test performance among middle-aged and older Hispanic/Latinos. METHODS Participants included 9639 Hispanic/Latino adults from the community-based and prospective Hispanic Community Health Study/Study of Latinos. At baseline (2008-2011; V1), participants self-reported their cancer history. At V1 and again at a 7-year follow-up (2015-2018; V2), trained technicians administered neurocognitive tests including the Brief-Spanish English Verbal Learning Test (B-SEVLT), Word Fluency Test (WF), and Digit Symbol Substitution Test (DSS). We used survey linear regression to estimate the overall, sex-specific, and cancer site-specific [i.e., cervix, breast, uterus, and prostate] adjusted associations between cancer history and neurocognitive test performance at V1 and changes from V1 to V2. RESULTS At V1, a history of cancer (6.4%) versus no history of cancer (93.6%) was associated with higher WF scores (β = 0.14, SE = 0.06; p = 0.03) and global cognition (β = 0.09, SE = 0.04; p = 0.04). Among women, a history of cervical cancer predicted decreases in SEVLT-Recall scores (β = -0.31, SE = 0.13; p = 0.02) from V1 to V2, and among men, a history of prostate cancer was associated with higher V1 WF scores (β = 0.29, SE = 0.12; p = 0.02) and predicted increases in SEVLT-Sum (β = 0.46, SE = 0.22; p = 0.04) from V1 to V2. CONCLUSION Among women, a history of cervical cancer was associated with 7-year memory decline, which may reflect the impacts of systemic cancer therapies. Among men, however, a history of prostate cancer was associated with improvements in cognitive performance, perhaps due in part to engaging in health promoting behaviors following cancer.
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Affiliation(s)
- Humberto Parada
- Division of Epidemiology and Biostatistics, School of Public HealthSan Diego State UniversitySan DiegoCaliforniaUSA
- UC San Diego Health Moores Cancer CenterLa JollaCaliforniaUSA
| | - Margaret S. Pichardo
- Department of SurgeryHospitals of the University of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Linda C. Gallo
- Department of PsychologySan Diego State UniversitySan DiegoCaliforniaUSA
| | | | - Corinne McDaniels‐Davidson
- Division of Health Promotion and Behavioral Science, School of Public HealthSan Diego State UniversitySan DiegoCaliforniaUSA
| | - Frank J. Penedo
- Departments of Psychology and MedicineUniversity of Miami College of Arts and Sciences and Miller School of MedicineMiamiFloridaUSA
| | - David J. Lee
- Department of Public Health SciencesUniversity of Miami Miller School of MedicineMiamiFloridaUSA
| | - Wassim Tarraf
- Institute of Gerontology and Department of Healthcare SciencesWayne State UniversityDetroitMichiganUSA
| | - Tayna P. Garcia
- Department of BiostatisticsUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Martha L. Daviglus
- Institute for Minority Health ResearchUniversity of Illinois ChicagoChicagoIllinoisUSA
| | - Hector M. González
- Department of NeurosciencesUniversity of California, San DiegoLa JollaCaliforniaUSA
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Granot-Hershkovitz E, He S, Bressler J, Yu B, Tarraf W, Rebholz CM, Cai J, Chan Q, Garcia TP, Mosley T, Kristal BS, DeCarli C, Fornage M, Chen GC, Qi Q, Kaplan R, Gonzalez HM, Sofer T. Plasma metabolites associated with cognitive function across race/ethnicities affirming the importance of healthy nutrition. Alzheimers Dement 2023; 19:1331-1342. [PMID: 36111689 PMCID: PMC10017373 DOI: 10.1002/alz.12786] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 06/08/2022] [Accepted: 07/22/2022] [Indexed: 11/05/2022]
Abstract
INTRODUCTION We studied the replication and generalization of previously identified metabolites potentially associated with global cognitive function in multiple race/ethnicities and assessed the contribution of diet to these associations. METHODS We tested metabolite-cognitive function associations in U.S.A. Hispanic/Latino adults (n = 2222) from the Community Health Study/ Study of Latinos (HCHS/SOL) and in European (n = 1365) and African (n = 478) Americans from the Atherosclerosis Risk In Communities (ARIC) Study. We applied Mendelian Randomization (MR) analyses to assess causal associations between the metabolites and cognitive function and between Mediterranean diet and cognitive function. RESULTS Six metabolites were consistently associated with lower global cognitive function across all studies. Of these, four were sugar-related (e.g., ribitol). MR analyses provided weak evidence for a potential causal effect of ribitol on cognitive function and bi-directional effects of cognitive performance on diet. DISCUSSION Several diet-related metabolites were associated with global cognitive function across studies with different race/ethnicities. HIGHLIGHTS Metabolites associated with cognitive function in Puerto Rican adults were recently identified. We demonstrate the generalizability of these associations across diverse race/ethnicities. Most identified metabolites are related to sugars. Mendelian Randomization (MR) provides weak evidence for a causal effect of ribitol on cognitive function. Beta-cryptoxanthin and other metabolites highlight the importance of a healthy diet.
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Affiliation(s)
- Einat Granot-Hershkovitz
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Shan He
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jan Bressler
- Human Genetics Center, School of Public Health University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Bing Yu
- Human Genetics Center, School of Public Health University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Wassim Tarraf
- Institute of Gerontology, Wayne State University, Detroit, MI, USA
| | - Casey M. Rebholz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jianwen Cai
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, CA, USA
| | - Queenie Chan
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Tanya P. Garcia
- Department of Neurology, School of medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Thomas Mosley
- Department of Neurology, School of medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Bruce S. Kristal
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Charles DeCarli
- Alzheimer’s Disease Center, Department of Neurology, University of California, Davis, Sacramento, CA, USA
| | - Myriam Fornage
- Brown Foundation Institute of Molecular Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Guo-Chong Chen
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
- Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, China
| | - Qibin Qi
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle WA, USA
| | - Robert Kaplan
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle WA, USA
| | - Hector M. Gonzalez
- Department of Neurosciences and Shiley-Marcos Alzheimer’s Disease Center, University of California, San Diego, La Jolla, CA, USA
| | - Tamar Sofer
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Vásquez PM, Tarraf W, Chai A, Doza A, Sotres-Alvarez D, Diaz KM, Zlatar ZZ, Durazo-Arvizu RA, Gallo LC, Estrella ML, Vásquez E, Evenson KR, Khambaty T, Thyagarajan B, Singer RH, Schneiderman N, Daviglus ML, González HM. Accelerometer-Measured Latent Physical Activity Profiles and Neurocognition Among Middle-Aged and Older Hispanic/Latino Adults in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). J Gerontol B Psychol Sci Soc Sci 2022; 77:e263-e278. [PMID: 36219450 PMCID: PMC9799203 DOI: 10.1093/geronb/gbac161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES Derive latent profiles of accelerometry-measured moderate-vigorous physical activity (MVPA) for Hispanic/Latino adults, examine associations between latent MVPA profiles and neurocognition, and describe profiles via self-reported MVPA. METHODS Complex survey design methods were applied to cross-sectional data from 7,672 adults ages 45-74 years in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL; 2008-2011). MVPA was measured via hip-worn accelerometers. Latent profile analysis was applied to derive latent MVPA profiles (minutes/day of week). Neurocognition was assessed with the Brief-Spanish English Verbal Learning Test (B-SEVLT) Sum, B-SEVLT Recall, Controlled Oral Word Association Test (word fluency), and Digit Symbol Substitution (DSS) test. All tests were z-scored, and a global neurocognition score was generated by averaging across scores. Survey linear regression models were used to examine associations between latent MVPA profiles and neurocognitive measures. Self-reported MVPA domains were estimated (occupational, transportation, and recreational) for each latent profile. RESULTS Four latent MVPA profiles from the overall adult target population (18-74 years) were derived and putatively labeled: No MVPA, low, moderate, and high. Only the high MVPA profile (compared to moderate) was associated with lower global neurocognition. Sensitivity analyses using latent MVPA profiles with only participants aged 45-74 years showed similar profiles, but no associations between latent MVPA profiles and neurocognition. The occupational MVPA domain led in all latent MVPA profiles. DISCUSSION We found no consistent evidence to link accelerometry-measured MVPA profiles to neurocognitive function. Research to better characterize the role of high occupational MVPA in relation to neurocognition among Hispanic/Latino adults are needed.
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Affiliation(s)
- Priscilla M Vásquez
- Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, California, USA
| | - Wassim Tarraf
- Institute of Gerontology and Department of Healthcare Services, Wayne State University, Detroit, Michigan, USA
| | - Albert Chai
- Department of Neuroscience, University of California San Diego, La Jolla, California, USA
| | - Adit Doza
- Institute of Gerontology and Department of Healthcare Services, Wayne State University, Detroit, Michigan, USA
| | - Daniela Sotres-Alvarez
- Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Keith M Diaz
- Department of Medicine, Columbia University Medical Center, New York, New York, USA
| | - Zvinka Z Zlatar
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - Ramon A Durazo-Arvizu
- Department of Pediatrics, University of Southern California, Los Angeles, California, USA
| | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Mayra L Estrella
- Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Elizabeth Vásquez
- School of Public Health, University at Albany, State University of New York, Rensselaer, New York, USA
| | - Kelly R Evenson
- Department of Epidemiology, Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | - Tasneem Khambaty
- Department of Psychology, University of Maryland Baltimore County, Baltimore, Maryland, USA
| | - Bharat Thyagarajan
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Richard H Singer
- Department of Oral Science and Translational Research, College of Dental Medicine, Nova Southeastern University, Ft. Lauderdale, Florida, USA
| | - Neil Schneiderman
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Martha L Daviglus
- Institute for Minority Health Research, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Hector M González
- Department of Neuroscience, University of California San Diego, La Jolla, California, USA
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Faaitiiti KL, Jupiter DC. Diabetes-Specific Dementia: A Structured Literature Review of Cognitive Assessment Methods. J Foot Ankle Surg 2022; 61:401-409. [PMID: 34893425 PMCID: PMC8936078 DOI: 10.1053/j.jfas.2021.11.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 11/08/2021] [Indexed: 02/03/2023]
Abstract
Diabetes mellitus is a known risk factor for the development of multiple subtypes of dementia and mild cognitive impairment. Recent research identifies a cause-specific diabetes-related dementia with a unique set of characteristics. Currently, there is no standard cognitive assessment battery recommended to specifically assess dementia that is a direct consequence of chronic diabetes, and some evaluations have been used for decades with minimal revisions, regardless of appropriateness. We performed a systematic review of the dementia/cognition evaluation methods most commonly used in the literature for assessing diabetic patients and identified which cognitive domains are typically assessed in this setting, and whether cognitive changes were more reflective of a vascular pathology, Alzheimer's pathology, or something else entirely. Search results yielded 1089 articles. After screening for appropriateness, a total of 11 full-text articles were assessed. In general, subjects in the reviewed studies were assessed using a variety of testing methods, examining different combinations of cognitive domains. A standard, clear definition of which cognitive domains are the most important to assess in diabetic patients is needed in order to determine what combination of assessment tools are most pertinent. Given the growing subset of the US population, careful reconsideration of cognitive assessment methods is needed to create self-care plans that take into account a specific collection of cognitive challenges for those with diabetes.
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Affiliation(s)
- Kelli L Faaitiiti
- Medical Student, School of Medicine, The University of Texas Medical Branch, Galveston, TX
| | - Daniel C Jupiter
- Associate Professor, Department of Preventive Medicine and Population Health, The University of Texas Medical Branch, Galveston, TX; Associate Professor, Department of Orthopaedic Surgery and Rehabilitation, The University of Texas Medical Branch, Galveston, TX.
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19
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He S, Granot‐Hershkovitz E, Zhang Y, Bressler J, Tarraf W, Yu B, Huang T, Zeng D, Wassertheil‐Smoller S, Lamar M, Daviglus M, Marquine MJ, Cai J, Mosley T, Kaplan R, Boerwinkle E, Fornage M, DeCarli C, Kristal B, Gonzalez HM, Sofer T. Blood metabolites predicting mild cognitive impairment in the study of Latinos-investigation of neurocognitive aging (HCHS/SOL). ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2022; 14:e12259. [PMID: 35229015 PMCID: PMC8865745 DOI: 10.1002/dad2.12259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 09/17/2021] [Accepted: 09/21/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Blood metabolomics-based biomarkers may be useful to predict measures of neurocognitive aging. METHODS We tested the association between 707 blood metabolites measured in 1451 participants from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), with mild cognitive impairment (MCI) and global cognitive change assessed 7 years later. We further used Lasso penalized regression to construct a metabolomics risk score (MRS) that predicts MCI, potentially identifying a different set of metabolites than those discovered in individual-metabolite analysis. RESULTS We identified 20 metabolites predicting prevalent MCI and/or global cognitive change. Six of them were novel and 14 were previously reported as associated with neurocognitive aging outcomes. The MCI MRS comprised 61 metabolites and improved prediction accuracy from 84% (minimally adjusted model) to 89% in the entire dataset and from 75% to 87% among apolipoprotein E ε4 carriers. DISCUSSION Blood metabolites may serve as biomarkers identifying individuals at risk for MCI among US Hispanics/Latinos.
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Affiliation(s)
- Shan He
- Department of BiostatisticsHarvard T.H Chan School of Public HealthBostonMassachusettsUSA
- Division of Sleep and Circadian DisordersBrigham and Women's HospitalBostonMassachusettsUSA
| | - Einat Granot‐Hershkovitz
- Division of Sleep and Circadian DisordersBrigham and Women's HospitalBostonMassachusettsUSA
- Department of MedicineHarvard Medical SchoolBostonMassachusettsUSA
| | - Ying Zhang
- Division of Sleep and Circadian DisordersBrigham and Women's HospitalBostonMassachusettsUSA
| | - Jan Bressler
- Human Genetics CenterSchool of Public Health, University of Texas Health Science Center at HoustonHoustonTexasUSA
| | - Wassim Tarraf
- Institute of GerontologyWayne State UniversityDetroitMichiganUSA
| | - Bing Yu
- Human Genetics CenterSchool of Public Health, University of Texas Health Science Center at HoustonHoustonTexasUSA
| | - Tianyi Huang
- Channing Division of Network MedicineBrigham and Women's HospitalBostonMassachusettsUSA
| | - Donglin Zeng
- Department of BiostatisticsGillings School of Global Public HealthUniversity of North CarolinaChapel HillNorth CarolinaUSA
| | - Sylvia Wassertheil‐Smoller
- Department of Epidemiology & Population HealthDepartment of PediatricsAlbert Einstein College of MedicineBronxNew YorkUSA
| | - Melissa Lamar
- Department of MedicineInstitute for Minority Health ResearchUniversity of Illinois at ChicagoChicagoIllinoisUSA
- Rush Alzheimer's Disease Research CenterRush University Medical CenterChicagoIllinoisUSA
| | - Martha Daviglus
- Department of MedicineInstitute for Minority Health ResearchUniversity of Illinois at ChicagoChicagoIllinoisUSA
| | - Maria J. Marquine
- Department of PsychiatryUniversity of California, San DiegoSan DiegoCaliforniaUSA
| | - Jianwen Cai
- Department of BiostatisticsGillings School of Global Public HealthUniversity of North CarolinaChapel HillNorth CarolinaUSA
| | - Thomas Mosley
- Department of MedicineUniversity of Mississippi Medical CenterJacksonMississippiUSA
| | - Robert Kaplan
- Department of Epidemiology & Population HealthDepartment of PediatricsAlbert Einstein College of MedicineBronxNew YorkUSA
- Division of Public Health SciencesFred Hutchinson Cancer Research CenterSeattleWashingtonUSA
| | - Eric Boerwinkle
- Human Genetics CenterSchool of Public Health, University of Texas Health Science Center at HoustonHoustonTexasUSA
- Human Genome Sequencing CenterBaylor College of MedicineHoustonTexasUSA
| | - Myriam Fornage
- Brown Foundation Institute of Molecular MedicineMcGovern Medical SchoolThe University of Texas Health Science Center at HoustonHoustonTexasUSA
| | - Charles DeCarli
- Department of Neurology, Alzheimerʼs Disease CenterUniversity of California, DavisSacramentoCaliforniaUSA
| | - Bruce Kristal
- Burke Medical Research Institute, White PlainsNew YorkUSA
- Departments of Biochemistry and NeuroscienceWeill Medical College of Cornell UniversityNew YorkNew YorkUSA
| | - Hector M. Gonzalez
- Department of Neurosciences and Shiley‐Marcos Alzheimer's Disease CenterUniversity of California, San DiegoLa JollaCaliforniaUSA
| | - Tamar Sofer
- Department of BiostatisticsHarvard T.H Chan School of Public HealthBostonMassachusettsUSA
- Division of Sleep and Circadian DisordersBrigham and Women's HospitalBostonMassachusettsUSA
- Department of MedicineHarvard Medical SchoolBostonMassachusettsUSA
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20
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Breton J, Stickel AM, Tarraf W, Gonzalez KA, Keamy AJ, Schneiderman N, Marquine MJ, Zlatar ZZ, Salmon DP, Lamar M, Daviglus ML, Lipton RB, Gallo LC, Goodman ZT, González HM. Normative data for the Brief Spanish-English Verbal Learning Test for representative and diverse Hispanics/Latinos: Results from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2021; 13:e12260. [PMID: 34934802 PMCID: PMC8650755 DOI: 10.1002/dad2.12260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 06/21/2021] [Accepted: 06/28/2021] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Episodic learning and memory performance are crucial components of cognitive assessment. To meet the needs of a diverse Hispanic/Latino population, we aimed to provide normative data on the Brief Spanish-English Verbal Learning Test (B-SEVLT). METHODS The target population for the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) included individuals 45+ years old from Central American, Cuban, Dominican, Mexican, Puerto Rican, and South American backgrounds. Average age was 56.5 years ± 9.92, 54.5% were female, and mean education was 11.0 years ± 5.6 (unweighted n = 9309). Participants were administered the B-SEVLT in their preferred language (Spanish or English). Hispanic/Latino background adjusted B-SEVLT scores and percentile cut-points were created using survey-adjusted regression models. RESULTS Higher educational attainment, younger age, and being female were associated with higher learning and memory performance. Hispanic/Latino background groups differed in B-SEVLT performance. DISCUSSION Representative learning and memory norms for Hispanic/Latinos of diverse backgrounds will improve cognitive assessment and accuracy of neurocognitive disorder diagnosis.
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Affiliation(s)
- Jordana Breton
- Department of PsychiatryUniversity of California San DiegoLa JollaCaliforniaUSA
| | - Ariana M. Stickel
- Department of Neurosciences and Shiley‐Marcos Alzheimer's Disease Research CenterUniversity of California San DiegoLa JollaCaliforniaUSA
| | - Wassim Tarraf
- Institute of Gerontology & Department of Healthcare SciencesWayne State UniversityDetroitMichiganUSA
| | - Kevin A. Gonzalez
- Department of Neurosciences and Shiley‐Marcos Alzheimer's Disease Research CenterUniversity of California San DiegoLa JollaCaliforniaUSA
| | - Alexandra J. Keamy
- Department of Neurosciences and Shiley‐Marcos Alzheimer's Disease Research CenterUniversity of California San DiegoLa JollaCaliforniaUSA
| | | | - María J. Marquine
- Department of PsychiatryUniversity of California San DiegoLa JollaCaliforniaUSA
- Department of MedicineUniversity of California San DiegoLa JollaCaliforniaUSA
| | - Zvinka Z. Zlatar
- Department of PsychiatryUniversity of California San DiegoLa JollaCaliforniaUSA
| | - David P. Salmon
- Department of Neurosciences and Shiley‐Marcos Alzheimer's Disease Research CenterUniversity of California San DiegoLa JollaCaliforniaUSA
| | - Melissa Lamar
- Institute for Minority Health ResearchUniversity of Illinois at ChicagoCollege of MedicineChicagoIllinoisUSA
- Rush Alzheimer's Disease CenterRush University Medical CenterChicagoIllinoisUSA
| | - Martha L. Daviglus
- Institute for Minority Health ResearchUniversity of Illinois at ChicagoCollege of MedicineChicagoIllinoisUSA
| | - Richard B. Lipton
- Departments of NeurologyEpidemiology & Population HealthAlbert Einstein College of MedicineNew YorkNew YorkUSA
| | - Linda C. Gallo
- Department of PsychologySan Diego State UniversitySan DiegoCaliforniaUSA
| | | | - Hector M. González
- Department of Neurosciences and Shiley‐Marcos Alzheimer's Disease Research CenterUniversity of California San DiegoLa JollaCaliforniaUSA
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Hamza Y, Zeng FG. Tinnitus Is Associated With Improved Cognitive Performance in Non-hispanic Elderly With Hearing Loss. Front Neurosci 2021; 15:735950. [PMID: 34776845 PMCID: PMC8581543 DOI: 10.3389/fnins.2021.735950] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 10/04/2021] [Indexed: 11/13/2022] Open
Abstract
Because hearing loss is a high-risk factor for cognitive decline, tinnitus, a comorbid condition of hearing loss, is often presumed to impair cognition. The present cross-sectional study aimed to delineate the interaction of tinnitus and cognition in the elderly with and without hearing loss after adjusting for covariates in race, age, sex, education, pure tone average, hearing aids, and physical well-being. Participants included 643 adults (60–69 years old; 51.3% females) from the National Health and Nutrition Examination Survey (NHANES, 2011–2012), and 1,716 (60–69 years old; 60.4% females) from the Hispanic Community Health Study (HCHS, 2008–2011). Multivariable linear and binary logistic regression was used to assess the association between tinnitus and cognition in the two sub-cohorts of normal hearing (NHANES, n = 508; HCHS, n = 1264) and hearing loss (NHANES, n = 135; HCHS, n = 453). Cognitive performance was measured as a composite z-score from four cognitive tests: The Consortium to Establish a Registry for Alzheimer’s Disease (CERAD)-word learning, CERAD-animal fluency, CERAD-word list recall, and the digit symbol substitution test (DSST) in NHANES, and a comparable Hispanic version of these four tests in HCHS. Multivariable linear regression revealed no association between tinnitus and cognition, except for the NHANES (non-Hispanic) participants with hearing loss, where the presence of tinnitus was associated with improved cognitive performance (Mean = 0.3; 95% CI, 0.1–0.5; p, 0.018). Using the 25th percentile score of the control (i.e., normal hearing and no tinnitus) as a threshold for poor cognitive performance, the absence of tinnitus increased the risk for poor cognitive performance (OR = 5.6, 95% CI, 1.9–17.2; p, 0.002). Sensitivity analysis found a positive correlation between tinnitus duration and cognitive performance in the NHANES cohort [F(4,140), 2.6; p, 0.037]. The present study finds no evidence for the assumption that tinnitus impairs cognitive performance in the elderly. On the contrary, tinnitus is associated with improved cognitive performance in the non-Hispanic elderly with hearing loss. The present result suggests that race be considered as an important and relevant factor in the experimental design of tinnitus research. Future longitudinal and imaging studies are needed to validate the present findings and understand their mechanisms.
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Affiliation(s)
- Yasmeen Hamza
- Center for Hearing Research, Department of Anatomy and Neurobiology, Biomedical Engineering, Cognitive Sciences, Otolaryngology-Head and Neck Surgery, University of California, Irvine, Irvine, CA, United States
| | - Fan-Gang Zeng
- Center for Hearing Research, Department of Anatomy and Neurobiology, Biomedical Engineering, Cognitive Sciences, Otolaryngology-Head and Neck Surgery, University of California, Irvine, Irvine, CA, United States
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Luchsinger JA, Younes N, Manly JJ, Barzilay J, Valencia W, Larkin ME, Falck-Ytter C, Krause-Steinrauf H, Pop-Busui R, Florez H, Seaquist E. Association of Glycemia, Lipids, and Blood Pressure With Cognitive Performance in People With Type 2 Diabetes in the Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study (GRADE). Diabetes Care 2021; 44:2286-2292. [PMID: 34285097 PMCID: PMC8740937 DOI: 10.2337/dc20-2858] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 06/19/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Type 2 diabetes is a risk factor for cognitive impairment. We examined the relation of glycemia, lipids, blood pressure (BP), hypertension history, and statin use with cognition in the Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study (GRADE). RESEARCH DESIGN AND METHODS Cross-sectional analyses from GRADE at baseline examined the association of glycemia (hemoglobin A1c [HbA1c]), LDL, systolic BP (SBP) and diastolic BP (DBP), hypertension history, and statin use with cognition assessed by the Spanish English Verbal Learning Test, letter and animal fluency tests, and Digit Symbol Substitution Test (DSST). RESULTS Among 5,047 GRADE participants, 5,018 (99.4%) completed cognitive assessments. Their mean age was 56.7 ± 10.0 years, and 36.4% were women. Mean diabetes duration was 4.0 ± 2.7 years. HbA1c was not related to cognition. Higher LDL was related to modestly worse DSST scores, whereas statin use was related to modestly better DSST scores. SBP between 120 and 139 mmHg and DBP between 80 and 89 mmHg were related to modestly better DSST scores. Hypertension history was not related to cognition. CONCLUSIONS In people with type 2 diabetes of a mean duration of <5 years, lower LDL and statin use were related to modestly better executive cognitive function. SBP levels in the range of 120-139 mmHg and DBP levels in the range of 80-89 mmHg, but not lower levels, were related to modestly better executive function. These differences may not be clinically significant.
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Affiliation(s)
- José A Luchsinger
- Departments of Medicine and Epidemiology, Columbia University Irving Medical Center, New York, NY
| | - Naji Younes
- The Biostatistics Center, Department of Bios-tatistics and Bioinformatics, Milken Institute of Public Health, The George Washington University, Rockville, MD
| | - Jennifer J Manly
- Department of Neurology, Columbia University Irving Medical Center, New York, NY
| | | | - Willy Valencia
- Department of Medicine, University of Miami, Miami, FL
- Geriatric Research Education and Clinical Center, Bruce W. Carter Veterans Affairs Medical Center, Miami, FL
| | - Mary E Larkin
- Massachusetts General Hospital Diabetes Center, Harvard Medical School, Boston, MA
| | - Corinna Falck-Ytter
- Department of Medicine, VA North East Ohio Healthcare System, Case Western Reserve University, Cleveland, OH
| | - Heidi Krause-Steinrauf
- The Biostatistics Center, Department of Bios-tatistics and Bioinformatics, Milken Institute of Public Health, The George Washington University, Rockville, MD
| | - Rodica Pop-Busui
- Division of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, University of Michigan, Ann Arbor, MI
| | - Hermes Florez
- Department of Medicine, University of Miami, Miami, FL
- Geriatric Research Education and Clinical Center, Bruce W. Carter Veterans Affairs Medical Center, Miami, FL
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Goodman ZT, Llabre MM, González HM, Lamar M, Gallo LC, Tarraf W, Perreira KM, López-Cevallos DF, Vásquez PM, Medina LD, Perera MJ, Zeng D, Bainter SA. Testing measurement equivalence of neurocognitive assessments across language in the Hispanic Community Health Study/Study of Latinos. Neuropsychology 2021; 35:423-433. [PMID: 34043392 DOI: 10.1037/neu0000725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE Neuropsychological instruments are often developed in English and translated to other languages to facilitate the clinical evaluation of diverse populations or to utilize in research environments. However, the psychometric equivalence of these assessments across language must be demonstrated before populations can validly be compared. METHOD To test this equivalence, we applied measurement invariance procedures to a subsample (N = 1,708) of the Hispanic Community Health Survey/Study of Latinos (HCHS/SOL) across English and Spanish versions of a neurocognitive battery. Using cardinality matching, 854 English-speaking and 854 Spanish-speaking subsamples were matched on age, education, sex, immigration status (U.S. born, including territories, or foreign-born), and Hispanic/Latino heritage background. Neurocognitive measures included the Six-Item Screener (SIS), Brief-Spanish English Verbal Learning Test (B-SEVLT), Word Fluency (WF), and Digit Symbol Substitution (DSS). Confirmatory factor analysis was utilized to test item-level invariance of the SIS, B-SEVLT, and WF, as well as factor-level invariance of a higher-order neurocognitive functioning latent variable. RESULTS One item of both the SIS and WF were more difficult in Spanish than English, as was the DSS test. After accounting for partial invariance, Spanish-speakers performed worse on each of the subtests and the second-order neurocognitive functioning latent variable. CONCLUSIONS We found some evidence of bias at both item and factor levels, contributing to the poorer neurocognitive performance of Spanish test-takers. While these results explain the underperformance of Spanish-speakers to some extent, more work is needed to determine whether such bias is reflective of true cognitive differences or additional variables unaccounted for in this study. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
| | | | | | - Melissa Lamar
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center
| | - Linda C Gallo
- Department of Psychology, San Diego State University
| | - Wassim Tarraf
- Department of Healthcare Sciences, Institute of Gerontology, Wayne State University
| | - Krista M Perreira
- Department of Social Medicine, University of North Carolina at Chapel Hill
| | | | | | | | | | - Donglin Zeng
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina
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Wilcock D, Jicha G, Blacker D, Albert MS, D’Orazio LM, Elahi FM, Fornage M, Hinman JD, Knoefel J, Kramer J, Kryscio RJ, Lamar M, Moghekar A, Prestopnik J, Ringman JM, Rosenberg G, Sagare A, Satizabal CL, Schneider J, Seshadri S, Sur S, Tracy RP, Yasar S, Williams V, Singh H, Mazina L, Helmer KG, Corriveau RA, Schwab K, Kivisäkk P, Greenberg SM. MarkVCID cerebral small vessel consortium: I. Enrollment, clinical, fluid protocols. Alzheimers Dement 2021; 17:704-715. [PMID: 33480172 PMCID: PMC8122220 DOI: 10.1002/alz.12215] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 09/22/2020] [Indexed: 01/04/2023]
Abstract
The concept of vascular contributions to cognitive impairment and dementia (VCID) derives from more than two decades of research indicating that (1) most older individuals with cognitive impairment have post mortem evidence of multiple contributing pathologies and (2) along with the preeminent role of Alzheimer's disease (AD) pathology, cerebrovascular disease accounts for a substantial proportion of this contribution. Contributing cerebrovascular processes include both overt strokes caused by etiologies such as large vessel occlusion, cardioembolism, and embolic infarcts of unknown source, and frequently asymptomatic brain injuries caused by diseases of the small cerebral vessels. Cerebral small vessel diseases such as arteriolosclerosis and cerebral amyloid angiopathy, when present at moderate or greater pathologic severity, are independently associated with worse cognitive performance and greater likelihood of dementia, particularly in combination with AD and other neurodegenerative pathologies. Based on this evidence, the US National Alzheimer's Project Act explicitly authorized accelerated research in vascular and mixed dementia along with frontotemporal and Lewy body dementia and AD itself. Biomarker development has been consistently identified as a key step toward translating scientific advances in VCID into effective prevention and treatment strategies. Validated biomarkers can serve a range of purposes in trials of candidate interventions, including (1) identifying individuals at increased VCID risk, (2) diagnosing the presence of cerebral small vessel disease or specific small vessel pathologies, (3) stratifying study participants according to their prognosis for VCID progression or treatment response, (4) demonstrating an intervention's target engagement or pharmacodynamic mechanism of action, and (5) monitoring disease progression during treatment. Effective biomarkers allow academic and industry investigators to advance promising interventions at early stages of development and discard interventions with low success likelihood. The MarkVCID consortium was formed in 2016 with the goal of developing and validating fluid- and imaging-based biomarkers for the cerebral small vessel diseases associated with VCID. MarkVCID consists of seven project sites and a central coordinating center, working with the National Institute of Neurologic Diseases and Stroke and National Institute on Aging under cooperative agreements. Through an internal selection process, MarkVCID has identified a panel of 11 candidate biomarker "kits" (consisting of the biomarker measure and the clinical and cognitive data used to validate it) and established a range of harmonized procedures and protocols for participant enrollment, clinical and cognitive evaluation, collection and handling of fluid samples, acquisition of neuroimaging studies, and biomarker validation. The overarching goal of these protocols is to generate rigorous validating data that could be used by investigators throughout the research community in selecting and applying biomarkers to multi-site VCID trials. Key features of MarkVCID participant enrollment, clinical/cognitive testing, and fluid biomarker procedures are summarized here, with full details in the following text, tables, and supplemental material, and a description of the MarkVCID imaging biomarker procedures in a companion paper, "MarkVCID Cerebral small vessel consortium: II. Neuroimaging protocols." The procedures described here address a range of challenges in MarkVCID's design, notably: (1) acquiring all data under informed consent and enrollment procedures that allow unlimited sharing and open-ended analyses without compromising participant privacy rights; (2) acquiring the data in a sufficiently wide range of study participants to allow assessment of candidate biomarkers across the various patient groups who might ultimately be targeted in VCID clinical trials; (3) defining a common dataset of clinical and cognitive elements that contains all the key outcome markers and covariates for VCID studies and is realistically obtainable during a practical study visit; (4) instituting best fluid-handling practices for minimizing avoidable sources of variability; and (5) establishing rigorous procedures for testing the reliability of candidate fluid-based biomarkers across replicates, assay runs, sites, and time intervals (collectively defined as the biomarker's instrumental validity). Participant Enrollment Project sites enroll diverse study cohorts using site-specific inclusion and exclusion criteria so as to provide generalizable validation data across a range of cognitive statuses, risk factor profiles, small vessel disease severities, and racial/ethnic characteristics representative of the diverse patient groups that might be enrolled in a future VCID trial. MarkVCID project sites include both prospectively enrolling centers and centers providing extant data and samples from preexisting community- and population-based studies. With approval of local institutional review boards, all sites incorporate MarkVCID consensus language into their study documents and informed consent agreements. The consensus language asks prospectively enrolled participants to consent to unrestricted access to their data and samples for research analysis within and outside MarkVCID. The data are transferred and stored as a de-identified dataset as defined by the Health Insurance Portability and Accountability Act Privacy Rule. Similar human subject protection and informed consent language serve as the basis for MarkVCID Research Agreements that act as contracts and data/biospecimen sharing agreements across the consortium. Clinical and Cognitive Data Clinical and cognitive data are collected across prospectively enrolling project sites using common MarkVCID instruments. The clinical data elements are modified from study protocols already in use such as the Alzheimer's Disease Center program Uniform Data Set Version 3 (UDS3), with additional focus on VCID-related items such as prior stroke and cardiovascular disease, vascular risk factors, focal neurologic findings, and blood testing for vascular risk markers and kidney function including hemoglobin A1c, cholesterol subtypes, triglycerides, and creatinine. Cognitive assessments and rating instruments include the Clinical Dementia Rating Scale, Geriatric Depression Scale, and most of the UDS3 neuropsychological battery. The cognitive testing requires ≈60 to 90 minutes. Study staff at the prospectively recruiting sites undergo formalized training in all measures and review of their first three UDS3 administrations by the coordinating center. Collection and Handling of Fluid Samples Fluid sample types collected for MarkVCID biomarker kits are serum, ethylenediaminetetraacetic acid-plasma, platelet-poor plasma, and cerebrospinal fluid (CSF) with additional collection of packed cells to allow future DNA extraction and analyses. MarkVCID fluid guidelines to minimize variability include fasting morning fluid collections, rapid processing, standardized handling and storage, and avoidance of CSF contact with polystyrene. Instrumental Validation for Fluid-Based Biomarkers Instrumental validation of MarkVCID fluid-based biomarkers is operationally defined as determination of intra-plate and inter-plate repeatability, inter-site reproducibility, and test-retest repeatability. MarkVCID study participants both with and without advanced small vessel disease are selected for these determinations to assess instrumental validity across the full biomarker assay range. Intra- and inter-plate repeatability is determined by repeat assays of single split fluid samples performed at individual sites. Inter-site reproducibility is determined by assays of split samples distributed to multiple sites. Test-retest repeatability is determined by assay of three samples acquired from the same individual, collected at least 5 days apart over a 30-day period and assayed on a single plate. The MarkVCID protocols are designed to allow direct translation of the biomarker validation results to multicenter trials. They also provide a template for outside groups to perform analyses using identical methods and therefore allow direct comparison of results across studies and centers. All MarkVCID protocols are available to the biomedical community and intended to be shared. In addition to the instrumental validation procedures described here, each of the MarkVCID kits will undergo biological validation to determine whether the candidate biomarker measures important aspects of VCID such as cognitive function. Analytic methods and results of these validation studies for the 11 MarkVCID biomarker kits will be published separately. The results of this rigorous validation process will ultimately determine each kit's potential usefulness for multicenter interventional trials aimed at preventing or treating small vessel disease related VCID.
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Affiliation(s)
- Donna Wilcock
- Sanders-Brown Center on Aging, University of Kentucky College of Medicine, Lexington, KY 40504, USA
| | - Gregory Jicha
- Sanders-Brown Center on Aging, University of Kentucky College of Medicine, Lexington, KY 40504, USA
| | - Deborah Blacker
- Department of Epidemiology, Harvard T.H Chan School of Public Health and Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA
| | - Marilyn S. Albert
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Lina M. D’Orazio
- Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA
| | - Fanny M. Elahi
- Center for Memory and Aging, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA 94143, USA
| | - Myriam Fornage
- Brown Foundation Institute of Molecular Medicine, McGovern Medical School and Human Genetics Center, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Jason D. Hinman
- David Geffen School of Medicine, Department of Neurology, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Janice Knoefel
- Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Joel Kramer
- David Geffen School of Medicine, Department of Neurology, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Richard J. Kryscio
- Sanders-Brown Center on Aging, University of Kentucky College of Medicine, Lexington, KY 40504, USA
| | - Melissa Lamar
- Rush Alzheimer’s Disease Center, Rush University, Chicago, IL, USA
| | - Abhay Moghekar
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Jillian Prestopnik
- Center for Memory and Aging, University of New Mexico Health Sciences Center, Albuquerque, NM 87131, USA
| | - John M. Ringman
- Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA
| | - Gary Rosenberg
- Center for Memory and Aging, University of New Mexico Health Sciences Center, Albuquerque, NM 87131, USA
| | - Abhay Sagare
- Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Claudia L. Satizabal
- Glenn Biggs Institute for Alzheimer’s & Neurodegenerative Diseases, University of Texas Health San Antonio, San Antonio, TX 78229, USA
| | - Julie Schneider
- Rush Alzheimer’s Disease Center, Rush University, Chicago, IL, USA
| | - Sudha Seshadri
- Glenn Biggs Institute for Alzheimer’s & Neurodegenerative Diseases, University of Texas Health San Antonio, San Antonio, TX 78229, USA
| | - Sandeepa Sur
- Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Russell P. Tracy
- Department of Pathology and Laboratory Medicine, University of Vermont Larner College of Medicine, Burlington, VT 05405, USA
| | - Sevil Yasar
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Victoria Williams
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705, USA
| | - Herpreet Singh
- Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Lidiya Mazina
- Neurological Clinical Research Institute, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Karl G. Helmer
- Department of Radiology, Massachusetts General Hospital, Boston, MA 02114, USA
| | | | - Kristin Schwab
- Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Pia Kivisäkk
- Alzheimer’s Clinical and Translational Research Unit, Massachusetts General Hospital, Boston, MA 02129, USA
| | - Steven M. Greenberg
- Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA
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Stickel AM, Tarraf W, Bainbridge KE, Viviano RP, Daviglus M, Dhar S, Gonzalez F, Zeng D, González HM. Hearing Sensitivity, Cardiovascular Risk, and Neurocognitive Function: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL). JAMA Otolaryngol Head Neck Surg 2021; 147:377-387. [PMID: 33331854 PMCID: PMC7747041 DOI: 10.1001/jamaoto.2020.4835] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Question Is hearing impairment associated with cardiovascular disease risk and cognitive function among Hispanic or Latino participants? Findings In this cohort study of 9623 Hispanic/Latino adults, hearing impairment was associated with poorer cognitive performance on all tasks, and cardiovascular disease risk did not attenuate these relationships. Rather, hearing impairment modified the associations between cardiovascular disease risk and learning and memory; only among individuals with hearing impairment, being identified as having excessively high glucose was associated with poorer learning and memory relative to participants considered healthy individuals. Meaning Hearing impairment may exacerbate the associations between high glucose and poorer cognition, particularly for learning and memory among Hispanic or Latino persons. Importance Both cardiovascular disease risk and hearing impairment are associated with cognitive dysfunction. However, the combined influence of the 2 risk factors on cognition is not well characterized. Objective To examine associations between hearing impairment, cardiovascular disease risk, and cognitive function. Design, Setting, and Participants This population-based, prospective cohort, multisite cross-sectional analysis of baseline data collected between 2008 and 2011 as part of the Hispanic Community Health Study/Study of Latinos included 9623 Hispanic or Latino adults aged 45 to 74 years in New York, Chicago, Miami, and San Diego. Exposures Hearing impairment of at least mild severity was defined as the pure tone average of 500, 1000, 2000, and 4000 Hz greater than 25 dB hearing level (dB HL) in the better ear. Our measure of cardiovascular disease risk was a latent class variable derived from body mass index, ankle-brachial index, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, fasting blood glucose, and the Framingham Cardiovascular Risk score. Main Outcomes and Measures Results on Brief-Spanish English Verbal Learning Test (episodic learning and memory), and Word Fluency (verbal fluency), and Digit Symbol Subtest (processing speed/executive functioning), and a cognitive composite of the mentioned tests (overall cognition). Results Participants (N = 9180) were 54.4% female and age 56.5 years on average. Hearing impairment was associated with poorer performance on all cognitive measures (global cognition: unstandardized β, −0.11; 95% CI, −0.16 to 0.07). Cardiovascular grouping (healthy, typical, high cardiovascular disease risk, and hyperglycemia) did not attenuate the associations between hearing impairment and cognition (global cognition: unstandardized β, −0.11; 95% CI, −0.15 to −0.06). However, cardiovascular grouping interacted with hearing impairment such that hyperglycemia in the context of hearing impairment exacerbated poor performance on learning and memory tasks (F3 = 3.70 and F3 = 2.92, respectively). Conclusions and Relevance The findings of this cohort study suggest that hearing impairment increases the likelihood that individuals with excessively high glucose perform poorly on learning and memory tasks. Further research is needed to specify the mechanisms by which cardiovascular disease risk and hearing impairment are collectively associated with cognition.
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Affiliation(s)
- Ariana M Stickel
- Department of Neurosciences and Shiley-Marcos Alzheimer's Disease Research Center, University of California San Diego, La Jolla
| | - Wassim Tarraf
- Institute of Gerontology, Wayne State University, Detroit, Michigan.,Department of Healthcare Sciences, Wayne State University, Detroit, Michigan
| | - Kathleen E Bainbridge
- National Institute on Deafness and Other Communication Disorders, Bethesda, Maryland
| | - Raymond P Viviano
- Institute of Gerontology, Wayne State University, Detroit, Michigan.,Department of Psychology, Wayne State University, Detroit, Michigan
| | - Martha Daviglus
- Institute for Minority Health Research, University of Illinois at Chicago, College of Medicine, Chicago
| | - Sumitrajit Dhar
- Department of Communication Sciences and Disorders, Northwestern University, Evanston, Illinois
| | - Franklyn Gonzalez
- Department of Biostatistics, University of North Carolina, Chapel Hill, North Carolina
| | - Donglin Zeng
- Department of Biostatistics, University of North Carolina, Chapel Hill, North Carolina
| | - Hector M González
- Department of Neurosciences and Shiley-Marcos Alzheimer's Disease Research Center, University of California San Diego, La Jolla
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Granot‐Hershkovitz E, Tarraf W, Kurniansyah N, Daviglus M, Isasi CR, Kaplan R, Lamar M, Perreira KM, Wassertheil‐Smoller S, Stickel A, Thyagarajan B, Zeng D, Fornage M, DeCarli CS, González HM, Sofer T. APOE alleles' association with cognitive function differs across Hispanic/Latino groups and genetic ancestry in the study of Latinos-investigation of neurocognitive aging (HCHS/SOL). Alzheimers Dement 2021; 17:466-474. [PMID: 33155766 PMCID: PMC8016734 DOI: 10.1002/alz.12205] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Apolipoprotein E (APOE) alleles are associated with cognitive decline, mild cognitive impairment (MCI), and Alzheimer's disease in Whites, but have weaker and inconsistent effects reported in Latinos. We hypothesized that this heterogeneity is due to ancestry-specific genetic effects. METHODS We investigated the associations of the APOE alleles with significant cognitive decline and MCI in 4183 Latinos, stratified by six Latino backgrounds, and explored whether the proportion of continental genetic ancestry (European, African, and Amerindian) modifies these associations. RESULTS APOE ε4 was associated with an increased risk of significant cognitive decline (odds ratio [OR] = 1.15, P-value = 0.03), with the strongest association in Cubans (OR = 1.46, P-value = 0.007). APOE-ε2 was associated with decreased risk of MCI (OR = 0.37, P-value = 0.04) in Puerto Ricans. Amerindian genetic ancestry was found to protect from the risk conferred by APOE ε4 on significant cognitive decline. DISCUSSION Results suggest that APOE alleles' effects on cognitive outcomes differ across six Latino backgrounds and are modified by continental genetic ancestry.
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Affiliation(s)
- Einat Granot‐Hershkovitz
- Division of Sleep and Circadian DisordersDepartment of Medicine, Brigham and Women's HospitalBostonMassachusettsUSA
- Department of MedicineHarvard Medical SchoolBostonMassachusettsUSA
| | - Wassim Tarraf
- Institute of GerontologyWayne State UniversityDetroitMichiganUSA
| | - Nuzulul Kurniansyah
- Division of Sleep and Circadian DisordersDepartment of Medicine, Brigham and Women's HospitalBostonMassachusettsUSA
| | - Martha Daviglus
- Department of Medicine, Institute for Minority Health ResearchUniversity of Illinois at ChicagoChicagoIllinoisUSA
| | - Carmen R. Isasi
- Department of Epidemiology & Population HealthDepartment of PediatricsAlbert Einstein College of MedicineBronxNew YorkUSA
| | - Robert Kaplan
- Department of Epidemiology & Population HealthDepartment of PediatricsAlbert Einstein College of MedicineBronxNew YorkUSA
- Division of Public Health SciencesFred Hutchinson Cancer Research CenterSeattleWashingtonUSA
| | - Melissa Lamar
- Department of Medicine, Institute for Minority Health ResearchUniversity of Illinois at ChicagoChicagoIllinoisUSA
- Rush Alzheimer's Disease Research CenterRush University Medical CenterChicagoIllinoisUSA
| | - Krista M. Perreira
- Department of Social MedicineUniversity of North Carolina School of MedicineChapel HillNorth CarolinaUSA
| | - Sylvia Wassertheil‐Smoller
- Department of Epidemiology & Population HealthDepartment of PediatricsAlbert Einstein College of MedicineBronxNew YorkUSA
| | - Ariana Stickel
- Department of Neurosciences and Shiley‐Marcos Alzheimer's Disease CenterUniversity of California, San DiegoLa JollaCaliforniaUSA
| | - Bharat Thyagarajan
- Department of Laboratory Medicine and PathologyUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Donglin Zeng
- Department of Biostatistics, Gillings School of Global Public HealthUniversity of North CarolinaChapel HillNorth CarolinaUSA
| | - Myriam Fornage
- Institute of Molecular MedicineThe University of Texas Health Science Center at HoustonHoustonTexasUSA
| | - Charles S. DeCarli
- Department of NeurologyCenter for NeuroscienceUniversity of California at DavisSacramentoCaliforniaUSA
| | - Hector M. González
- Department of Neurosciences and Shiley‐Marcos Alzheimer's Disease CenterUniversity of California, San DiegoLa JollaCaliforniaUSA
| | - Tamar Sofer
- Division of Sleep and Circadian DisordersDepartment of Medicine, Brigham and Women's HospitalBostonMassachusettsUSA
- Department of MedicineHarvard Medical SchoolBostonMassachusettsUSA
- Department of BiostatisticsHarvard T.H. Chan School of Public HealthBostonMassachusettsUSA
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27
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McIntosh RC, Khambaty T, Llabre MM, Perreira KM, Gonzalez HM, Kansal MM, Tarraf W, Schneiderman N. Paradoxical effect of cumulative stress exposure on information processing speed in Hispanics/Latinos with elevated heart rate variability. Int J Psychophysiol 2021; 164:1-8. [PMID: 33524438 DOI: 10.1016/j.ijpsycho.2021.01.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 01/24/2021] [Accepted: 01/26/2021] [Indexed: 11/19/2022]
Abstract
Chronic stress has a deleterious effect on prefrontal lobe functioning. Empirical evidence suggests elevated vagal tone, indexed by elevated heart rate variability (HRV), mitigates the effect of mental stress on frontal lobe function. Here, the mitigating effect of HRV on stress-related decrements in cognitive performance is assessed based on information processing speed (DSST), word fluency and verbal learning task performance. Artifact free electrocardiogram (ECG) data was analyzed from 1420 Hispanic/Latino adults from the Sociocultural Ancillary of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). A 12-lead ECG was used to collect short-term recordings of the root mean square of successive differences in all normal R-peak to R-peak intervals (RMSSD) and the change between adjacent beats and the standard deviation of those intervals (SDNN) as indices of total HRV. As predicted, an interaction emerged for HRV and stress on the task presumed to require the greatest prefrontal lobe involvement, i.e., the DSST. After accounting for sociodemographic factors, chronic stress was associated with better DSST performance amongst individuals at higher quartile of SDNN, but not RMSSD. The paradoxical effect for greater stress exposure on DSST performance may in part be explained by increased speed of information processing and decision making often reported in high-stress cohorts. The nature of this interaction highlights the importance of examining the relationship between stress and cognition across a spectrum of vagal tone.
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Affiliation(s)
- Roger C McIntosh
- Department of Psychology, University of Miami, Coral Gables, FL 33124, United States of America.
| | - Tasneem Khambaty
- Department of Psychology, University of Maryland, Baltimore County, MD 21250, United States of America.
| | - Maria M Llabre
- Department of Psychology, University of Miami, Coral Gables, FL 33124, United States of America.
| | - Krista M Perreira
- Department of Social Medicine, UNC at Chapel Hill, Chapel Hill 27599, United States of America.
| | - Hector M Gonzalez
- Department of Neurosciences, University of California San Diego, San Diego, CA 92093, United States of America.
| | - Mayank M Kansal
- Internal Medicine/Cardiology, University of Illinois at Chicago, Chicago, IL 60612, United States of America.
| | - Wassim Tarraf
- Institute of Gerontology and Department of Healthcare Sciences, Wayne State University, Detroit, MI 48202, United States of America.
| | - Neil Schneiderman
- Department of Psychology, University of Miami, Coral Gables, FL 33124, United States of America.
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28
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Paredes AM, Gooding A, Fortuny LAI, Mindt MR, Suárez P, Scott TM, Heaton A, Heaton RK, Cherner M, Marquine MJ. The state of neuropsychological test norms for Spanish-speaking adults in the United States. Clin Neuropsychol 2021; 35:236-252. [PMID: 32141802 PMCID: PMC7484438 DOI: 10.1080/13854046.2020.1729866] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 01/27/2020] [Accepted: 02/09/2020] [Indexed: 01/10/2023]
Abstract
Objective: The present review paper aimed to identify published neuropsychological test norms developed for Spanish-speakers living in the United States (U.S.). Methods: We conducted a systematic review of the literature via an electronic search on PubMed using keywords "Normative data," "Neuropsychological test," "norms", "Hispanic/Latinos," "Spanish Speakers," and "United States." We added other studies and published manuals as identified by citations in papers from the original search. Results Eighteen sources of normative data for Spanish-speakers in the U.S. were identified. Of the 18 citations identified, only four provide normative data on comprehensive batteries of tests for Spanish-Speakers. Two of these are based on persons living in the southwest of the U.S., who tend to be of Mexican origin. Overall, a number of the studies are focused on older persons and although the majority include participants with wide ranges of education, participants in the ends of the education distribution tend to be underrepresented. Conclusion: Here we provide a detailed description of the neuropsychological normative data currently available for Spanish-speakers living in the U.S. While there has been increased attention towards developing norms for neuropsychological batteries in Spanish-speaking countries (e.g., Latin America and Spain), there is still an urgent need to standardize neuropsychological tests among diverse groups of Spanish-speaking adults living in the U.S. The present review presents a list of norms for U.S.-dwelling Spanish-speakers, thus providing an important tool for clinicians and researchers.
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Affiliation(s)
| | - Amanda Gooding
- Department of Psychiatry, University of California San Diego, United States
| | | | - Monica Rivera Mindt
- Department of Psychology and Latin American and Latina/o Studies Institute, Fordham University, New York, New York
- Department of Neurology, The Icahn School of Medicine at Mount Sinai, New York, New York
| | - Paola Suárez
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Travis M. Scott
- Department of Psychology and Latin American and Latina/o Studies Institute, Fordham University, New York, New York
- VA Palo Alto Health Care System, Sierra Pacific MIRECC
| | - Anne Heaton
- Department of Psychiatry, University of California San Diego, United States
| | - Robert K. Heaton
- Department of Psychiatry, University of California San Diego, United States
| | - Mariana Cherner
- Department of Psychiatry, University of California San Diego, United States
| | - María J. Marquine
- Department of Psychiatry, University of California San Diego, United States
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29
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Ilango SD, Gonzalez K, Gallo L, Allison MA, Cai J, Isasi CR, Hosgood HD, Vasquez PM, Zeng D, Mortamais M, Gonzalez H, Benmarhnia T. Long-Term Exposure to Ambient Air Pollution and Cognitive Function Among Hispanic/Latino Adults in San Diego, California. J Alzheimers Dis 2021; 79:1489-1496. [PMID: 33492285 PMCID: PMC10896012 DOI: 10.3233/jad-200766] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Hispanics/Latinos in the United States are more likely to live in neighborhoods with greater exposure to air pollution and are projected to have the largest increase in dementia among race/ethnic minority groups. OBJECTIVE We examined the associations of air pollution with performance on cognitive function tests in Hispanic/Latino adults. METHODS We used data from the San Diego site of the Hispanic Community Health Study/Study of Latinos, an ongoing cohort of Hispanics/Latinos. This analysis focused on individuals ≥45 years of age who completed a neurocognitive battery examining overall mental status, verbal learning, memory, verbal fluency, and executive function (n = 2,089). Air pollution (PM2.5 and O3) before study baseline was assigned to participants' zip code. Logistic and linear regression were used to estimate the associations of air pollution on overall mental status and domain-specific standardized test scores. Models accounted for complex survey design, demographic, and socioeconomic characteristics. RESULTS We found that for every 10μg/m3 increase in PM2.5, verbal fluency worsened (β: -0.21 [95%CI: -0.68, 0.25]). For every 10 ppb increase in O3, verbal fluency and executive function worsened (β: -0.19 [95%CI: -0.34, -0.03]; β: -0.01 [95%CI: -0.01, 0.09], respectively). We did not identify any detrimental effect of pollutants on other domains. CONCLUSION Although we found suggestions that air pollution may impact verbal fluency and executive function, we observed no consistent or precise evidence to suggest an adverse impact of air pollution on cognitive level among this cohort of Hispanic/Latino adults.
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Affiliation(s)
- Sindana D. Ilango
- School of Public Health, San Diego State University, San Diego, CA, USA
- Department of Family Medicine and Public Health, UC San Diego, La Jolla, CA, USA
| | - Kevin Gonzalez
- Department of Neurosciences, UC San Diego, La Jolla, CA, USA
| | - Linda Gallo
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Matthew A. Allison
- Department of Family Medicine and Public Health, UC San Diego, La Jolla, CA, USA
| | - Jianwen Cai
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Carmen R. Isasi
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, New York, NY, USA
| | - H. Dean Hosgood
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Priscilla M. Vasquez
- Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
| | - Donglin Zeng
- Department of Biostatistics, University of North Carolina Gillings School of Global Public Health, Chapel Hill, USA
| | - Marion Mortamais
- Neuropsychiatry Epidemiological and Clinical Research, INSERM, University of Montpellier, Montpellier, France
| | - Hector Gonzalez
- Department of Neurosciences, UC San Diego, La Jolla, CA, USA
| | - Tarik Benmarhnia
- Department of Family Medicine and Public Health, UC San Diego, La Jolla, CA, USA
- Scripps Institution of Oceanography, UC San Diego, La Jolla, CA, USA
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30
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Estrella ML, Durazo-Arvizu RA, Gallo LC, Tarraf W, Isasi CR, Perreira KM, Zeng D, Marquine MJ, Lipton RB, González HM, Daviglus ML, Lamar M. Psychosocial Factors Associated with Cognitive Function Among Middle-Aged and Older Hispanics/Latinos: The Hispanic Community Health Study/Study of Latinos and its Sociocultural Ancillary Study. J Alzheimers Dis 2020; 79:433-449. [PMID: 33285630 DOI: 10.3233/jad-200612] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Evidence suggests that psychosocial factors are associated with cognitive health in older adults; however, associations of psychosocial factors with cognition remain largely unexamined in middle-aged and older Hispanics/Latinos. OBJECTIVE To examine the cross-sectional associations of psychosocial factors with cognitive function among middle-aged and older Hispanics/Latinos living in the US. METHODS Baseline (2008-2011) data from the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study (n = 2,818; ages 45-74) were used to examine the associations of each psychosocial factor with global cognition (GC), verbal learning, verbal memory, verbal fluency, and processing speed independent of age, sex, education, Hispanic/Latino background, income, language, and depressive symptoms. Psychosocial variables included: intrapersonal factors (ethnic identity, optimism, and purpose in life), interpersonal factors (family cohesion, familism, social network embeddedness, and social support), and social stressors (perceived ethnic discrimination, loneliness, and subjective social status). RESULTS In fully-adjusted models, purpose in life and social support were each positively associated with all five cognitive variables. Loneliness was negatively associated with GC, verbal learning, memory, and processing speed. Ethnic identity was positively and familism negatively associated with GC, verbal fluency, and processing speed. Family cohesion was positively associated with verbal learning. CONCLUSION These findings extend previous evidence from older, largely non-Hispanic White cohorts to show that higher purpose in life and social support are also strongly associated with cognitive health among middle-aged and older Hispanics/Latinos. We also highlight that intrapersonal factors, interpersonal factors, and social stressors have differential relationships with individual cognitive tests.
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Affiliation(s)
- Mayra L Estrella
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL, USA
| | | | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Wassim Tarraf
- Institute of Gerontology and Department of Healthcare Sciences, Wayne State University, Detroit, MI, USA
| | - Carmen R Isasi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Krista M Perreira
- Department of Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Donglin Zeng
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Maria J Marquine
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Richard B Lipton
- Department of Neurology, Albert Einstein College of Medicine, New York, NY, USA
| | - Hector M González
- Department of Neurosciences and Shiley-Marcos Alzheimer's Disease Research Center, University of California, San Diego, San Diego, CA, USA
| | - Martha L Daviglus
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL, USA
| | - Melissa Lamar
- Department of Psychiatry and Behavioral Sciences and Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
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Lamar M, León A, Romo K, Durazo-Arvizu RA, Sachdeva S, Lipton RB, Perreira KM, Gallo LC, Cai J, Khambaty T, Carrasco J, Llabre MM, Eyler LT, Daviglus ML, González HM. The Independent and Interactive Associations of Bilingualism and Sex on Cognitive Performance in Hispanics/Latinos of the Hispanic Community Health Study/Study of Latinos. J Alzheimers Dis 2020; 71:1271-1283. [PMID: 31524155 DOI: 10.3233/jad-190019] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Sixty percent of Hispanics/Latinos are bilingual which research suggests may confer certain cognitive advantages. Female sex confers cognitive advantages in verbal learning and memory compared to male sex, regardless of race or ethnicity. Understanding the independent and interactive associations of bilingualism and sex with cognition may aid in predicting cognitive aging in Hispanics/Latinos. We examined baseline (2008-2011) data from the Hispanic Community Health Study/Study of Latinos, a multicenter, prospective community-based study. Our analyses included 6,110 males and females ≥45 years old who self-reported birth and parents' origin outside of the continental US, Spanish as their first language, and were evaluated in Spanish. Bilingualism was assessed along a Likert scale (1 = only Spanish to 4 = English>Spanish) for language proficiency (reading/spoken) and patterns of use (thinking/socializing). Cognitive testing included verbal learning, memory, fluency, and Digit Symbol Substitution (DSS). Linear regression models adjusted for relevant confounders, the complex survey design, and sampling weights. Participants' self-reported language proficiency was Spanish better than English, while patterns of use suggested more Spanish than English. Higher language proficiency was associated with higher performance on all cognitive indices while higher patterns of use associated with higher fluency and DSS scores (p-values < 0.01). Female sex was associated with higher performance on all cognitive indices (p-values < 0.05). There were no significant interactions with bilingualism (regardless of metric) by sex on cognition. For Hispanics/Latinos residing in the continental US and reporting birth and parents' origin elsewhere, bilingualism and female sex have independent cognitive benefits that are important to consider when evaluating cognitive performance.
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Affiliation(s)
- Melissa Lamar
- Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA.,Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL, USA.,Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.,Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Adeline León
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Karina Romo
- University of Minnesota Medical School, Minneapolis, MN, USA
| | - Ramon A Durazo-Arvizu
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL, USA.,Department of Public Health Sciences, Loyola University, Chicago, IL, USA
| | - Shruti Sachdeva
- Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA.,Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL, USA
| | - Richard B Lipton
- Department of Neurology, Albert Einstein College of Medicine, New York, NY, USA
| | - Krista M Perreira
- Department of Social Medicine, School of Medicine, University of North Carolina at Chapel Hill, NC, USA
| | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Jianwen Cai
- Department of Biostatistics, Collaborative Studies Coordinating Center, University of North Carolina, Chapel Hill, NC, USA
| | - Tasneem Khambaty
- Department of Psychology, University of Maryland, Baltimore County (UMBC), Baltimore, MD, USA
| | - Jessica Carrasco
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Maria M Llabre
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Lisa T Eyler
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Martha L Daviglus
- Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA.,Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL, USA
| | - Hector M González
- Department of Neuroscience, Shiley-Marcos Alzheimer's Disease Research Center, University of California San Diego, San Diego, CA, USA
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Estrella ML, Durazo-Arvizu RA, Mattei J, Mossavar-Rahmani Y, Perreira KM, Siega-Riz AM, Sotres-Alvarez D, González HM, Gallo LC, Daviglus ML, Lamar M. Alternate Healthy Eating Index is Positively Associated with Cognitive Function Among Middle-Aged and Older Hispanics/Latinos in the HCHS/SOL. J Nutr 2020; 150:1478-1487. [PMID: 32091597 PMCID: PMC7269746 DOI: 10.1093/jn/nxaa023] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Revised: 11/04/2019] [Accepted: 01/27/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Diet quality may be an important area of focus for promoting cognitive health; however, the association between diet quality and cognitive function among Hispanics/Latinos remains largely unexamined. We hypothesized that a healthier diet quality will be associated with better cognitive function in middle-aged and older Hispanics/Latinos. OBJECTIVE The objective of this study was to examine associations between the Alternate Healthy Eating Index (AHEI-2010), a measure of diet quality, and cognitive function in middle-aged and older Hispanics/Latinos. METHODS Data from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) Visit 1 (2008-2011) were used (n = 8461; ages 45-74 y). Cognitive function was assessed with tests of verbal learning and memory, verbal fluency, and processing speed; a global cognition score was derived by summing the z scores of individual tests. Dietary intake was assessed via two 24-h recalls. Total AHEI-2010 score was categorized into quintiles (higher quintiles indicating healthier diet). Linear regression models were used to examine associations between AHEI-2010 quintiles and cognitive function adjusting for sociodemographic characteristics, daily energy intake, type 2 diabetes, smoking, and depressive symptoms. RESULTS Compared with the lowest quintile, in the second to fourth AHEI-2010 quintiles, global cognition scores were significantly higher by 0.28, 0.52, and 0.48 units (P-trend = 0.042). In the second to fifth AHEI-2010 quintiles, verbal learning scores were significantly higher by 0.60, 0.62, 0.92, and 0.88 units, and verbal memory scores were higher by 0.33, 0.40, 0.52, and 0.46 units (P-trend = 0.020 and 0.007, respectively). No associations were observed between the AHEI-2010 and verbal fluency or processing speed (P-trend = 0.49 and 0.84, respectively). Among AHEI-2010 components, adequate consumption of vegetables, alcohol, and whole fruits were each associated with better cognitive function. CONCLUSIONS An overall healthier diet quality was associated with better global cognition, verbal learning, and verbal memory in middle-aged and older Hispanics/Latinos.
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Affiliation(s)
- Mayra L Estrella
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL 60612, USA
| | | | - Josiemer Mattei
- Department of Nutrition, Harvard University TH Chan School of Public Health, Boston, MA 02115, USA
| | - Yasmin Mossavar-Rahmani
- Departments of Medicine and Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Krista M Perreira
- Department of Social Medicine, School of Medicine, University of North Carolina at Chapel Hill, NC 27599, USA
| | - Anna Maria Siega-Riz
- School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA 01003, USA
| | - Daniela Sotres-Alvarez
- Collaborative Studies Coordinating Center, Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC 27516, USA
| | - Hector M González
- Department of Neuroscience, Shiley-Marcos Alzheimer's Disease Research Center, University of California San Diego, San Diego, CA 92093, USA
| | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, CA 92182, USA
| | - Martha L Daviglus
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Melissa Lamar
- Rush Alzheimer's Disease Center and Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL 60612, USA
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Estrella ML, Durazo-Arvizu RA, Gallo LC, Isasi CR, Perreira KM, Vu THT, Vasquez E, Sachdeva S, Zeng D, Llabre MM, Tarraf W, González HM, Daviglus ML, Lamar M. Associations between perceived neighborhood environment and cognitive function among middle-aged and older women and men: Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study. Soc Psychiatry Psychiatr Epidemiol 2020; 55:685-696. [PMID: 31974810 PMCID: PMC7276286 DOI: 10.1007/s00127-019-01829-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Accepted: 12/24/2019] [Indexed: 12/31/2022]
Abstract
PURPOSE To examine cross-sectional associations between perceived neighborhood environment and cognitive function among middle-aged and older Hispanic/Latino women and men. METHODS Data from the Hispanic Community Health Study/Study of Latinos (2008-2011) and its Sociocultural Ancillary Study (2009-2010) were used. Participants were Hispanic/Latino women (n = 1812) and men (n = 1034) aged 45-74 years. Survey-weighted linear regression models were used to examine associations between self-reported perceived neighborhood environment (i.e., neighborhood social cohesion and problems categorized as quintiles, and neighborhood safety from crime categorized as low, medium, or high) with cognitive function (i.e., global cognition, verbal learning, memory, verbal fluency, and processing speed scores) in women and men. Final model adjusted for age, Hispanic/Latino background, language, field site, household income, education, years lived in neighborhood, and depressive symptoms. RESULTS Women in the lowest quintile of perceived neighborhood problems (vs. highest quintile) had higher global cognition (β 0.48, 95% CI 0.03, 0.94, p trend 0.229) and memory scores (0.60, 95% CI 0.11, 1.09, p trend: 0.060). Women in the highest quintile of perceived neighborhood social cohesion (vs. lowest quintile) had lower global cognition (β - 0.56, 95% CI - 1.02, - 0.09, p trend 0.004), verbal learning (B - 1.01, 95% CI - 2.00, - 0.03, p trend 0.015), verbal fluency (B - 2.00, 95% CI - 3.83, - 0.16, p trend 0.006), and processing speed (B - 2.11, 95% CI - 3.87, - 0.36, p trend 0.009). There was no association between perceived neighborhood safety from crime and cognition among women, or between any perceived neighborhood environment measure and cognition among men. CONCLUSIONS Middle-aged and older Hispanic/Latina women living in neighborhoods with the lowest perceived problems had higher global cognition and memory. Women living in neighborhoods with the highest perceived social cohesion had lower global cognition, verbal learning, verbal fluency, and processing speed.
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Affiliation(s)
- Mayra L Estrella
- Institute for Minority Health Research, University of Illinois At Chicago, Chicago, IL, USA.
| | - Ramon A Durazo-Arvizu
- Institute for Minority Health Research, University of Illinois At Chicago, Chicago, IL, USA
- Department of Public Health Sciences, Loyola University Chicago, Chicago, IL, USA
| | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Carmen R Isasi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Krista M Perreira
- Department of Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Thanh-Huyen T Vu
- Department of Preventive Medicine, Northwestern University, Chicago, IL, USA
| | - Elizabeth Vasquez
- Department of Epidemiology and Biostatistics, University at Albany State University of New York, Albany, NY, USA
| | - Shruti Sachdeva
- Institute for Minority Health Research, University of Illinois At Chicago, Chicago, IL, USA
| | - Donglin Zeng
- Collaborative Studies Coordinating Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Maria M Llabre
- Department of Psychology, University of Miami, Miami, FL, USA
| | - Wassim Tarraf
- Department of Healthcare Sciences, Wayne State University, Detroit, MI, USA
| | - Hector M González
- Department of Neurosciences and Shiley-Marcos Alzheimer's Disease Research Center, University of California San Diego, La Jolla, CA, USA
| | - Martha L Daviglus
- Institute for Minority Health Research, University of Illinois At Chicago, Chicago, IL, USA
| | - Melissa Lamar
- Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
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Levine DA, Galecki AT, Okullo D, Briceño EM, Kabeto MU, Morgenstern LB, Langa KM, Giordani B, Brook R, Sanchez BN, Lisabeth LD. Association of Blood Pressure and Cognition after Stroke. J Stroke Cerebrovasc Dis 2020; 29:104754. [PMID: 32370925 DOI: 10.1016/j.jstrokecerebrovasdis.2020.104754] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 01/29/2020] [Accepted: 02/10/2020] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND AND AIM It is unclear whether blood pressure (BP) is associated with cognition after stroke. We examined associations between systolic and diastolic BP (SBP, DBP), pulse pressure (PP), mean arterial pressure (MAP), and cognition, each measured 90 days after stroke. METHODS Cross-sectional analysis of prospectively obtained data of 432 dementia-free subjects greater than or equal to 45 (median age, 66; 45% female) with stroke (92% ischemic; median NIH stroke score, 3 [IQR, 2-6]) from the population-based Brain Attack Surveillance in Corpus Christi (BASIC) project in 2011-2013. PRIMARY OUTCOME Modified Mini-Mental Status Examination (3MSE; range, 0-100). SECONDARY OUTCOMES Animal Fluency Test (AFT; range, 0-10) and Trail Making Tests A and B (number of correct items [range, 0-25]/completion time [Trails A: 0-180 seconds; Trails B: 0-300 second]). Linear or tobit regression adjusted associations for age, education, and race/ethnicity as well as variables significantly associated with BP and cognition. RESULTS Higher SBP, lower DBP, higher PP, and lower MAP each were associated with worse cognitive performance for all 4 tests (all P < .001). After adjusting for patient factors, no BP measures were associated with any of the 4 tests (all P > .05). Lower cognitive performance was associated with older age, less education, Mexican American ethnicity, diabetes, higher stroke severity, more depressive symptoms, and lower BMI. Among survivors with hypertension, anti-hypertensive medication use 90 days after stroke was significantly associated with higher AFT scores (P = .02) but not other tests (P > .15). CONCLUSIONS Stroke survivors' BP levels were not associated with cognitive performance at 90 days independent of sociodemographic and clinical factors.
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Affiliation(s)
- Deborah A Levine
- Departments of Internal Medicine and Neurology, and University of Michigan Cognitive Health Services Research Program, University of Michigan Medical School, Ann Arbor, Michigan.
| | - Andrzej T Galecki
- Department of Internal Medicine, University of Michigan Medical School, and Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Dolorence Okullo
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan
| | - Emily M Briceño
- Department of Physical Medicine and Rehabilitation, University of Michigan Medical School, Ann Arbor, Michigan
| | - Mohammed U Kabeto
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan
| | | | - Kenneth M Langa
- Department of Internal Medicine, University of Michigan Medical School and VA Ann Arbor Healthcare System, Ann Arbor, Michigan
| | - Bruno Giordani
- Departments of Psychiatry and Neurology, University of Michigan Medical School, Professor of Psychology, University of Michigan College of Literature, Science, and the Arts, Ann Arbor, Michigan
| | - Robert Brook
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan
| | - Brisa N Sanchez
- Department of Epidemiology and Biostatistics, Drexel University, Dornsife School of Public Health, Philadelphia, Pennsylvania
| | - Lynda D Lisabeth
- Department of Neurology, University of Michigan Medical School, and Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan
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González HM, Tarraf W, González KA, Fornage M, Zeng D, Gallo LC, Talavera GA, Daviglus ML, Lipton RB, Kaplan R, Ramos AR, Lamar M, Cai J, DeCarli C, Schneiderman N. Diabetes, Cognitive Decline, and Mild Cognitive Impairment Among Diverse Hispanics/Latinos: Study of Latinos-Investigation of Neurocognitive Aging Results (HCHS/SOL). Diabetes Care 2020; 43:1111-1117. [PMID: 32139382 PMCID: PMC7171942 DOI: 10.2337/dc19-1676] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 01/27/2020] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Hispanics/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 METHODS The 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), probability-sampled (i.e., representative of targeted populations), and prospective cohort study. Between 2016 and 2018, SOL-INCA enrolled diverse Hispanics/Latinos aged ≥50 years (n = 6,377). Global cognitive decline and mild cognitive impairment (MCI) were the primary outcomes. RESULTS Prevalent diabetes at visit 1, but not incident diabetes at visit 2, was associated with significantly steeper global cognitive decline (βGC = -0.16 [95% CI -0.25; -0.07]; 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. CONCLUSIONS Diabetes 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 middle-aged and older Hispanics/Latinos.
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Affiliation(s)
- Hector M González
- Department of Neurosciences and Shiley-Marcos Alzheimer's Disease Research Center, University of California, San Diego, San Diego, CA
| | - Wassim Tarraf
- Institute of Gerontology and Department of Healthcare Sciences, Wayne State University, Detroit, MI
| | - Kevin A González
- Department of Neurosciences and Shiley-Marcos Alzheimer's Disease Research Center, University of California, San Diego, San Diego, CA
| | | | - Donglin Zeng
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
| | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, CA
| | | | - Martha L Daviglus
- Institute for Minority Health Research, College of Medicine, University of Illinois at Chicago, Chicago, IL
| | | | - Robert Kaplan
- Albert Einstein College of Medicine, New York, NY.,Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
| | | | - Melissa Lamar
- Institute for Minority Health Research, College of Medicine, University of Illinois at Chicago, Chicago, IL.,Department of Psychiatry and Behavioral Sciences and Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL
| | - Jianwen Cai
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
| | - Charles DeCarli
- Department of Neurology and Alzheimer's Disease Center, University of California, Davis, Sacramento, CA
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Lamar M, Durazo-Arvizu RA, Rodriguez CJ, Kaplan RC, Perera MJ, Cai J, Espinoza Giacinto RA, González HM, Daviglus ML. Associations of Lipid Levels and Cognition: Findings from the Hispanic Community Health Study/Study of Latinos. J Int Neuropsychol Soc 2020; 26:251-262. [PMID: 31543086 PMCID: PMC7083682 DOI: 10.1017/s1355617719001000] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Hispanics/Latinos in the United States are less aware of their cholesterol levels and have a higher burden of associated adverse cardiovascular and cerebrovascular outcomes than non-Latino whites. Investigations of the associations between cholesterol levels and cognition in this population have often occurred within the context of metabolic syndrome and are limited to select lipids despite the fact that triglycerides (TGs) may be more relevant to the health of Hispanics/Latinos. METHODS Baseline data from the Hispanic Community Health Study/Study of Latinos, collected from 2008 to 2011, was used to investigate the associations of lipid levels (i.e., TG, total cholesterol, TC; low-density and high-density lipoprotein cholesterol, LDL-C and HDL-C) with cognition (i.e., learning, memory, verbal fluency, and digit symbol substitution, DSS), adjusting for relevant confounders. RESULTS In 7413 participants ages 45 to 74 years from Central American, Cuban, Dominican, Mexican, Puerto Rican, and South American backgrounds, separate, fully adjusted linear regression models revealed that TG levels were inversely associated with DSS performance; however, this relationship was no longer significant once additional cardiovascular disease risk factors were added to the model (p = .06). TC and LDL-C levels (separately) were positively associated with learning and verbal fluency regardless of adjustments (p-values < .05). Separate analyses investigating the effect modification by background and sex revealed a particularly robust association between TC levels and DSS performance for Puerto Ricans and Central Americans (albeit in opposite directions) and an inverse relationship between TG levels and DSS performance for women (p-values < .02). CONCLUSIONS It is important to consider individual lipid levels and demographic characteristics when investigating associations between cholesterol levels and cognition in Hispanics/Latinos.
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Affiliation(s)
- Melissa Lamar
- Department of Medicine, University of Illinois at Chicago, Chicago, IL
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL
- Rush Alzheimer’s Disease Center and Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL
| | - Ramon A. Durazo-Arvizu
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL
- Department of Public Health Sciences, Loyola University, Chicago, IL
| | - Carlos J. Rodriguez
- Department of Epidemiology & Prevention, Wake Forest University School of Medicine, Winston-Salem, NC
| | - Robert C. Kaplan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle WA 98109
| | | | - Jianwen Cai
- Department of Biostatistics, Collaborative Studies Coordinating Center, University of North Carolina, Chapel Hill, NC
| | - Rebeca A. Espinoza Giacinto
- Department of Psychology, University of California San Diego, San Diego, CA
- Division of Health Promotion and Behavioral Sciences, University of California San Diego, San Diego, CA
| | - Hector M. González
- Department of Neuroscience, Shiley-Marcos Alzheimer’s Disease Research Center, University of California San Diego, San Diego, CA
| | - Martha L. Daviglus
- Department of Medicine, University of Illinois at Chicago, Chicago, IL
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL
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Golub JS, Brickman AM, Ciarleglio AJ, Schupf N, Luchsinger JA. Audiometric Age-Related Hearing Loss and Cognition in the Hispanic Community Health Study. J Gerontol A Biol Sci Med Sci 2020; 75:552-560. [PMID: 31183502 PMCID: PMC7328204 DOI: 10.1093/gerona/glz119] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Age-related hearing loss (HL), a common and treatable condition, has been associated with other age-related conditions. Late life cognitive impairment is a major public health concern that is rarely treatable. Studies examining the relationship between HL and cognition have been limited by non-Hispanic cohorts, small samples, or limited confounding control. We overcome these limitations in a large Hispanic cohort. METHODS This was a multisite cross-sectional study of 5,277 subjects at least 50 years old (Hispanic Community Health Study, HCHS). The main exposure was audiometric HL. The main outcome measure was neurocognitive performance ascertained by the Digit Symbol Substitution Test (DSST), Word Frequency Test, Spanish-English Verbal Learning Test (SEVLT), and Six-Item Screener. RESULTS The mean age was 58.4 years (SD = 6.2). A 20-dB (equivalent to a one-category worsening) increase in HL was associated with a -1.53 (95% CI, -2.11, -0.94) raw score point difference in the DSST, adjusting for demographics, hearing aid use, and cardiovascular disease. Similarly, a 20-dB increase in HL was associated with a -0.86 (-1.23, -0.49) point difference on the Word Frequency Test, -0.76 (-1.04, -0.47) on the SEVLT 3 trials, -0.45 (-0.60, -0.29) on the SELVT recall, and -0.07 (-0.12, -0.02) on the Six-Item Screener. CONCLUSIONS In the largest study of formal, audiometric HL and cognition to date, HL was independently associated with worse performance in a range of neurocognitive measures. Because HL is common and potentially treatable, it should be investigated as a modifiable risk factor for neurocognitive decline and dementia.
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Affiliation(s)
- Justin S Golub
- Department of Otolaryngology—Head and Neck Surgery, Columbia University Irving Medical Center, New York
| | - Adam M Brickman
- Department of Neurology, the Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, and the Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, NewYork-Presbyterian/Columbia University Irving Medical Center, New York
| | - Adam J Ciarleglio
- Department of Epidemiology and Biostatistics, Milken Institute School of Public Health, George Washington University, Washington, DC
| | - Nicole Schupf
- Department of Neurology, the Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, and the Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, NewYork-Presbyterian/Columbia University Irving Medical Center, New York
- Department of Epidemiology, Joseph P. Mailman School of Public Health, Columbia University, New York
| | - José A Luchsinger
- Department of Epidemiology, Joseph P. Mailman School of Public Health, Columbia University, New York
- Department of Medicine, Vagelos College of Physicians and Surgeons, NewYork-Presbyterian/Columbia University Irving Medical Center, New York
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Stickel AM, Tarraf W, Wu B, Marquine MJ, Vásquez PM, Daviglus M, Estrella ML, Perreira KM, Gallo LC, Lipton RB, Isasi CR, Kaplan R, Zeng D, Schneiderman N, González HM. Cognition and Daily Functioning: Results from the Hispanic Community Health Study/Study of Latinos (SOL) and Study of Latinos-Investigation of Neurocognitive Aging (SOL-INCA). J Alzheimers Dis 2020; 77:1267-1278. [PMID: 32831203 PMCID: PMC7945678 DOI: 10.3233/jad-200502] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Among older adults, poorer cognitive functioning has been associated with impairments in instrumental activities of daily living (IADLs). However, IADL impairments among older Hispanics/Latinos is poorly understood. OBJECTIVE To characterize the relationships between cognition and risk for IADL impairment among diverse Hispanics/Latinos. METHODS Participants included 6,292 community-dwelling adults from the Study of Latinos - Investigation of Neurocognitive Aging, an ancillary study of 45+ year-olds in the Hispanic Community Health Study/Study of Latinos. Cognitive data (learning, memory, executive functioning, processing speed, and a Global cognitive composite) were collected at Visit 1. IADL functioning was self-reported 7 years later, and treated as a categorical (i.e., risk) and continuous (i.e., degree) measures of impairment. Survey two-part models (mixture of logit and generalized linear model with Gaussian distribution) and ordered logistic regression tested the associations of cognitive performance (individual tests and composite z-score) with IADL impairment. Additionally, we investigated the moderating role of age, sex, and Hispanic/Latino background on the association between cognition and IADL impairment. RESULTS Across all cognitive measures, poorer performance was associated with higher odds of IADL impairment 7 years later. Associations were generally stronger for the oldest group (70+ years) relative to the youngest group (50-59 years). Sex and Hispanic/Latino background did not modify the associations. Across the full sample, lower scores on learning, memory, and the Global cognitive composite were also associated with higher degree of IADL impairment. CONCLUSION Across diverse Hispanics/Latinos, cognitive health is an important predictor of everyday functioning 7 years later, especially in older adulthood.
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Affiliation(s)
- Ariana M. Stickel
- Department of Neurosciences and Shiley-Marcos Alzheimer’s Disease Research Center, UC San Diego
| | - Wassim Tarraf
- Institute of Gerontology & Department of Healthcare Sciences, Wayne State University, Detroit, Michigan
| | - Benson Wu
- Department of Neurosciences and Shiley-Marcos Alzheimer’s Disease Research Center, UC San Diego
| | | | | | - Martha Daviglus
- Institute for Minority Health Research, University of Illinois at Chicago, College of Medicine, Chicago, Illinois
| | - Mayra L. Estrella
- Institute for Minority Health Research, University of Illinois at Chicago, College of Medicine, Chicago, Illinois
| | - Krista M. Perreira
- Department of Social Medicine, UNC School of Medicine, Chapel Hill, North Carolina
| | - Linda C. Gallo
- Department of Psychology, San Diego State University, San Diego, California
| | - Richard B. Lipton
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine
| | - Carmen R. Isasi
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine
| | - Robert Kaplan
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine
| | - Donglin Zeng
- Department of Biostatistics, University of North Carolina, Chapel Hill, North Carolina
| | | | - Hector M. González
- Department of Neurosciences and Shiley-Marcos Alzheimer’s Disease Research Center, UC San Diego
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Golub JS, Brickman AM, Ciarleglio AJ, Schupf N, Luchsinger JA. Association of Subclinical Hearing Loss With Cognitive Performance. JAMA Otolaryngol Head Neck Surg 2020; 146:57-67. [PMID: 31725853 PMCID: PMC6865840 DOI: 10.1001/jamaoto.2019.3375] [Citation(s) in RCA: 98] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Accepted: 09/16/2019] [Indexed: 12/17/2022]
Abstract
Importance Age-related hearing loss (HL) is a common and treatable condition that has been associated with cognitive impairment. The level of hearing at which this association begins has not been studied to date. Objective To investigate whether the association between hearing and cognition is present among individuals traditionally classified as having normal hearing. Design, Setting, and Participants Cross-sectional study of 2 US epidemiologic studies (Hispanic Community Health Study [HCHS], 2008-2011, and National Health and Nutrition Examination Study [NHANES], 1999-2000, 2001-2002, and 2011-2012 cycles). The dates of analysis were November 2018 to August 2019. Multivariable generalized additive model (GAM) regression and linear regression were used to assess the association between HL (exposure) and cognition (outcome). Participants included 6451 individuals aged 50 years or older from the general Hispanic population (HCHS [n = 5190]) and the general civilian, noninstitutionalized US population (NHANES [n = 1261]). Exposures Audiometric HL (4-frequency pure-tone average). Main Outcomes and Measures Neurocognitive performance measured by the Digit Symbol Substitution Test (DSST) (score range, 0-113), Word Frequency Test (range, 0-49), Spanish-English Verbal Learning Test (SEVLT) 3 trials (range, 5-40), SEVLT recall (range, 0-15), and Six-Item Screener (range, 0-6); higher scores indicated better cognitive performance. Results Among 6451 individuals, the mean (SD) age was 59.4 (6.1) years, and 3841 (59.5%) were women. The GAM regression showed a significant inverse association between hearing and cognition across the entire spectrum of hearing after adjusting for demographics and cardiovascular disease. In separate multivariable linear regressions stratified by the classic binary definition of HL, decreased hearing was independently associated with decreased cognition in adults with normal hearing (pure-tone average ≤25 dB) across all cognitive tests in the HCHS. For example in this group, a 10-dB decrease in hearing was associated with a clinically meaningful 1.97-point (95% CI, 1.18-2.75) decrease in score on the DSST. When using a stricter HL cut point (15 dB), an association was also present in NHANES. The associations between hearing and cognition were stronger or equivalent in individuals with normal hearing than among those with HL. For example, there was a 2.28-point (95% CI, 1.56-3.00) combined cohort DSST score decrease per 10-dB decrease among individuals with normal hearing vs a 0.97-point (95% CI, 0.20-1.75) decrease among those with HL, with a significant interaction term between continuous and binary hearing. Conclusions and Relevance An independent association was observed between cognition and subclinical HL. The association between hearing and cognition may be present earlier in HL than previously understood. Studies investigating whether treating HL can prevent impaired cognition and dementia should consider a lower threshold for defining HL than the current 25-dB threshold.
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Affiliation(s)
- Justin S. Golub
- Department of Otolaryngology–Head and Neck Surgery, Vagelos College of Physicians and Surgeons, New York-Presbyterian/Columbia University Irving Medical Center, Columbia University, New York
| | - Adam M. Brickman
- Department of Neurology, Taub Institute for Research in Alzheimer’s Disease and the Aging Brain, and Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, New York-Presbyterian/Columbia University Irving Medical Center, Columbia University, New York
| | - Adam J. Ciarleglio
- Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, George Washington University, Washington, DC
| | - Nicole Schupf
- Department of Neurology, Taub Institute for Research in Alzheimer’s Disease and the Aging Brain, and Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, New York-Presbyterian/Columbia University Irving Medical Center, Columbia University, New York
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - José A. Luchsinger
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
- Department of Medicine, Vagelos College of Physicians and Surgeons, New York-Presbyterian/Columbia University Irving Medical Center, Columbia University, New York
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González HM, Tarraf W, Fornage M, González KA, Chai A, Youngblood M, Abreu MDLA, Zeng D, Thomas S, Talavera GA, Gallo LC, Kaplan R, Daviglus ML, Schneiderman N. A research framework for cognitive aging and Alzheimer's disease among diverse US Latinos: Design and implementation of the Hispanic Community Health Study/Study of Latinos-Investigation of Neurocognitive Aging (SOL-INCA). Alzheimers Dement 2019; 15:1624-1632. [PMID: 31759880 PMCID: PMC6925624 DOI: 10.1016/j.jalz.2019.08.192] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 08/14/2019] [Accepted: 08/14/2019] [Indexed: 01/07/2023]
Abstract
Hispanics/Latinos are the largest ethnic/racial group in the United States and at high risk for Alzheimer's disease and related dementia (ADRD). Yet, ADRD among diverse Latinos is poorly understood and disparately understudied or unstudied compared to other ethnic/racial groups that leave the nation ill-prepared for major demographic shifts that lay ahead in coming decades. The primary purpose of this Perspectives article was to provide a new research framework for advancing Latino ADRD knowledge, encompassing the unique sociocultural, cardiometabolic, and genomic aspects of Latino health, aging, and ADRD. In addition, we describe some of the research challenges to progress in Latino ADRD research. Finally, we present the Study of Latinos - Investigation of Neurocognitive Aging (SOL-INCA) as an example of implementing this new framework for advancing Latino ADRD research.
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Affiliation(s)
- Hector M González
- Department of Neurosciences and Shiley-Marcos Alzheimer's Disease Research Center, UC San Diego, La Jolla, CA, USA.
| | - Wassim Tarraf
- Department of Healthcare Sciences, Wayne State University, Institute of Gerontology, Detroit, MI, USA
| | - Myriam Fornage
- Department of Molecular Medicine and Human Genetics, University of Texas Health Science Center, Houston, TX, USA
| | - Kevin A González
- Department of Neurosciences and Shiley-Marcos Alzheimer's Disease Research Center, UC San Diego, La Jolla, CA, USA
| | - Albert Chai
- Department of Neurosciences and Shiley-Marcos Alzheimer's Disease Research Center, UC San Diego, La Jolla, CA, USA
| | - Marston Youngblood
- Department of Biostatistics, University of North Carolina, Collaborative Studies Coordinating Center, Chapel Hill, NC, USA
| | - Maria de Los Angeles Abreu
- Department of Biostatistics, University of North Carolina, Collaborative Studies Coordinating Center, Chapel Hill, NC, USA
| | - Donglin Zeng
- Department of Biostatistics, University of North Carolina, Collaborative Studies Coordinating Center, Chapel Hill, NC, USA
| | - Sonia Thomas
- RTI International, Research Triangle Park, NC, USA
| | - Gregory A Talavera
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Robert Kaplan
- Albert Einstein, College of Medicine, The Bronx, NY, USA; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Martha L Daviglus
- University of Illinois at Chicago, Institute for Minority Health Research, Chicago, IL, USA
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Castro-Schilo L, Fredrickson BL, Mungas D. Association of Positive Affect with Cognitive Health and Decline for Elder Mexican Americans. JOURNAL OF HAPPINESS STUDIES 2019; 20:2385-2400. [PMID: 31798315 PMCID: PMC6889886 DOI: 10.1007/s10902-018-0053-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The goal of this study was to investigate the linkages of positive affect (PA) with cognitive health and its decline among elder Mexican Americans. We conducted secondary analysis of longitudinal data from the Sacramento Area Latino Study on Aging (SALSA). We used the structural equation modeling framework to achieve three specific aims: (1) identify a valid measure of PA, (2) describe within-person trajectories of PA and cognitive health, and (3) test the inter-relations of these two processes over time. Results showed that, on average, PA and cognitive ability (including verbal memory) decreased over time. Yet, there was significant variability in these patterns of change. Bivariate latent growth curve models showed significant correlations of baseline levels and rates of change of PA and cognitive ability even after controlling for age, education, sex, bilingualism, and depression. Results support the hypothesis that increases and decreases in PA tend to be related to increases and decreases in cognitive health at old age among Mexican Americans.
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González HM, Tarraf W, Schneiderman N, Fornage M, Vásquez PM, Zeng D, Youngblood M, Gallo LC, Daviglus ML, Lipton RB, Kaplan R, Ramos AR, Lamar M, Thomas S, Chai A, DeCarli C. Prevalence and correlates of mild cognitive impairment among diverse Hispanics/Latinos: Study of Latinos-Investigation of Neurocognitive Aging results. Alzheimers Dement 2019; 15:1507-1515. [PMID: 31753701 DOI: 10.1016/j.jalz.2019.08.202] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 08/29/2019] [Accepted: 08/30/2019] [Indexed: 01/01/2023]
Abstract
INTRODUCTION We estimated the prevalence and correlates of mild cognitive impairment (MCI) among middle-aged and older diverse Hispanics/Latinos. METHODS Middle-aged and older diverse Hispanics/Latinos enrolled (n = 6377; 50-86 years) in this multisite prospective cohort study were evaluated for MCI using the National Institute on Aging-Alzheimer's Association diagnostic criteria. RESULTS The overall MCI prevalence was 9.8%, which varied between Hispanic/Latino groups. Older age, high cardiovascular disease (CVD) risk, and elevated depressive symptoms were significant correlates of MCI prevalence. Apolipoprotein E4 (APOE) and APOE2 were not significantly associated with MCI. DISCUSSION MCI prevalence varied among Hispanic/Latino backgrounds, but not as widely as reported in the previous studies. CVD risk and depressive symptoms were associated with increased MCI, whereas APOE4 was not, suggesting alternative etiologies for MCI among diverse Hispanics/Latinos. Our findings suggest that mitigating CVD risk factors may offer important pathways to understanding and reducing MCI and possibly dementia among diverse Hispanics/Latinos.
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Affiliation(s)
- Hector M González
- Department of Neurosciences, Shiley-Marcos Alzheimer's Disease Research Center, UC San Diego, San Diego, CA, USA.
| | - Wassim Tarraf
- Department of Healthcare Sciences, Wayne State University, Institute of Gerontology, Detroit, MI, USA
| | | | - Myriam Fornage
- University of Texas Health Science Center, Houston, TX, USA
| | - Priscilla M Vásquez
- Department of Neurosciences, Shiley-Marcos Alzheimer's Disease Research Center, UC San Diego, San Diego, CA, USA
| | - Donglin Zeng
- Department of Biostatistics, University of North Carolina, Collaborative Studies Coordinating Center, Chapel Hill, NC, USA
| | - Marston Youngblood
- Department of Biostatistics, University of North Carolina, Collaborative Studies Coordinating Center, Chapel Hill, NC, USA
| | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Martha L Daviglus
- Institute for Minority Health Research, University of Illinois at Chicago, College of Medicine, Chicago, IL, USA
| | | | - Robert Kaplan
- Albert Einstein, College of Medicine, New York, NY, USA; Fred Hutchinson Cancer Research Center, Division of Public Health Sciences, Seattle WA, USA
| | - Alberto R Ramos
- Department of Neurology, University of Miami, Miami, FL, USA
| | - Melissa Lamar
- Institute for Minority Health Research, University of Illinois at Chicago, College of Medicine, Chicago, IL, USA; Department of Psychiatry and Behavioral Sciences, Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Sonia Thomas
- RTI International, Research Triangle Park, NC, USA
| | - Albert Chai
- Department of Neurosciences, Shiley-Marcos Alzheimer's Disease Research Center, UC San Diego, San Diego, CA, USA
| | - Charles DeCarli
- Department of Neurology, Alzheimer's Disease Center, UC Davis, Sacramento, CA, USA
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Elfassy T, Aiello AE, Schneiderman N, Haan MN, Tarraf W, González HM, Gellman M, Florez HJ, Luchsinger JA, Wright CB, Grober E, Zeki Al Hazzouri A. Relation of Diabetes to Cognitive Function in Hispanics/Latinos of Diverse Backgrounds in the United States. J Aging Health 2019; 31:1155-1171. [PMID: 29577792 PMCID: PMC7020246 DOI: 10.1177/0898264318759379] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives:To examine the association between diabetes and cognitive function within U.S. Hispanics/Latinos of Central American, Cuban, Dominican, Mexican, Puerto Rican, and South American background. Method: This cross-sectional study included 9,609 men and women (mean age = 56.5 years), who are members of the Hispanic Community Health Study/Study of Latinos. We classified participants as having diabetes, prediabetes, or normal glucose regulation. Participants underwent a neurocognitive battery consisting of tests of verbal fluency, delayed recall, and processing speed. Analyses were stratified by Hispanic/Latino subgroup. Results: From fully adjusted linear regression models, compared with having normal glucose regulation, having diabetes was associated with worse processing speed among Cubans (β = -1.99; 95% CI [confidence interval] = [-3.80, -0.19]) and Mexicans (β = -2.26; 95% CI = [-4.02, -0.51]). Compared with having normal glucose regulation, having prediabetes or diabetes was associated with worse delayed recall only among Mexicans (prediabetes: β = -0.34; 95% CI = [-0.63, -0.05] and diabetes: β = -0.41; 95% CI = [-0.79, -0.04]). No associations with verbal fluency. Discussion: The relationship between diabetes and cognitive function varied across Hispanic/Latino subgroup.
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Affiliation(s)
- Tali Elfassy
- Department of Public Health Sciences, Division of Epidemiology, University of Miami
| | - Allison E. Aiello
- Department of Epidemiology, UNC Gillings School of Global Public Health, University of North Carolina at Chapel Hill
| | | | - Mary N. Haan
- Department of Epidemiology & Biostatistics, University of California San Francisco
| | - Wassim Tarraf
- Institute of Gerontology and Department of Healthcare Sciences, Wayne State University
| | | | | | - Hermes J. Florez
- Department of Public Health Sciences, Division of Epidemiology, University of Miami
| | - Jose A. Luchsinger
- Department of Medicine, Columbia University Medical Center, New York
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York
| | - Clinton B. Wright
- Director of Division of Clinical Research, National Institute of Neurological Disorders and Stroke, Bethesda, MD (CW)
| | - Ellen Grober
- Department of Neurology, Albert Einstein College of Medicine, NY (E.G.)
| | - Adina Zeki Al Hazzouri
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York
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van den Noort M, Vermeire K, Bosch P, Staudte H, Krajenbrink T, Jaswetz L, Struys E, Yeo S, Barisch P, Perriard B, Lee SH, Lim S. A Systematic Review on the Possible Relationship Between Bilingualism, Cognitive Decline, and the Onset of Dementia. Behav Sci (Basel) 2019; 9:E81. [PMID: 31340609 PMCID: PMC6680432 DOI: 10.3390/bs9070081] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 07/17/2019] [Accepted: 07/18/2019] [Indexed: 12/20/2022] Open
Abstract
A systematic review was conducted to investigate whether bilingualism has a protective effect against cognitive decline in aging and can protect against dementia. We searched the Medline, ScienceDirect, Scopus, and ERIC databases with a cut-off date of 31 March, 2019, thereby following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) protocol. Our search resulted in 34 eligible studies. Mixed results were found with respect to the protective effect of bilingualism against cognitive decline. Several studies showed a protective effect whereas other studies failed to find it. Moreover, evidence for a delay of the onset of dementia of between 4 and 5.5 years in bilingual individuals compared to monolinguals was found in several studies, but not in all. Methodological differences in the set-up of the studies seem to explain these mixed results. Lifelong bilingualism is a complex individual process, and many factors seem to influence this and need to be further investigated. This can be best achieved through large longitudinal studies with objective behavioral and neuroimaging measurements. In conclusion, although some evidence was found for a cognitive reserve-enhancing effect of lifelong bilingualism and protection against dementia, to date, no firm conclusions can be drawn.
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Affiliation(s)
- Maurits van den Noort
- Research Group of Pain and Neuroscience, Kyung Hee University, Seoul 130-701, Korea.
- Brussels Institute for Applied Linguistics, Vrije Universiteit Brussel, Brussels 1050, Belgium.
| | - Katrien Vermeire
- Department of Communication Sciences and Disorders, Long Island University (LIU) Brooklyn, Brooklyn, NY 11201, USA
| | - Peggy Bosch
- Psychiatric Research Group, LVR-Klinik Bedburg-Hau, 47511 Bedburg-Hau, Germany
- Donders Institute for Brain, Cognition, and Behaviour, Radboud University, 6525 Nijmegen, The Netherlands
| | - Heike Staudte
- Psychiatric Research Group, LVR-Klinik Bedburg-Hau, 47511 Bedburg-Hau, Germany
| | - Trudy Krajenbrink
- Department of Medicine, Neurology, University of Fribourg, 1700 Fribourg, Switzerland
| | - Lars Jaswetz
- Behavioural Science Institute, Radboud University, 6525 Nijmegen, The Netherlands
| | - Esli Struys
- Brussels Institute for Applied Linguistics, Vrije Universiteit Brussel, Brussels 1050, Belgium
| | - Sujung Yeo
- College of Oriental Medicine, Sang Ji University, Wonju 26339, Korea
| | - Pia Barisch
- Department of Psychology, Ruhr University Bochum, 44801 Bochum, Germany
| | - Benoît Perriard
- Department of Medicine, Neurology, University of Fribourg, 1700 Fribourg, Switzerland
| | - Sook-Hyun Lee
- Research Group of Pain and Neuroscience, Kyung Hee University, Seoul 130-701, Korea
| | - Sabina Lim
- Research Group of Pain and Neuroscience, Kyung Hee University, Seoul 130-701, Korea.
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Lamar M, Durazo-Arvizu RA, Sachdeva S, Pirzada A, Perreira KM, Rundek T, Gallo LC, Grober E, DeCarli C, Lipton RB, Tarraf W, González HM, Daviglus ML. Cardiovascular disease risk factor burden and cognition: Implications of ethnic diversity within the Hispanic Community Health Study/Study of Latinos. PLoS One 2019; 14:e0215378. [PMID: 31009492 PMCID: PMC6476505 DOI: 10.1371/journal.pone.0215378] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 04/01/2019] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE Hispanics/Latinos have some of the highest prevalence rates for cardiovascular disease risk factors, but stark differences exist by self-reported background. Cardiovascular disease risk factors negatively impact cognition in Hispanics/Latinos; less is known about these relationships by Hispanic/Latino backgrounds. We investigated cognitive associations with cardiovascular disease risk factor burden in a diverse cohort, the Hispanic Community Health Study/Study of Latinos. METHODS Baseline data from this observational study of cardiovascular disease and its antecedents was collected from 2008-2011. We included 7,121 participants 45-74 years old from Central American, Cuban, Dominican, Mexican, Puerto Rican, or South American backgrounds. Dichotomous indicators for hypertension, diabetes, hypercholesterolemia, obesity, and smoking were evaluated and totaled, with participants grouped by lowest (0-2), middle (3) or highest (4-5) burden. Cognitive testing included the Brief Spanish English Verbal Learning Test, letter fluency, and digit symbol substitution. RESULTS In separate fully-adjusted linear regression models, lower fluency and digit symbol substitution performance were restricted to the highest compared to the lowest burden group; whereas the middle burden group displayed impaired memory performance compared to the lowest burden group (p-values≤0.05). Background interacted with burden for learning and memory performance. That is, the association of burden level (i.e., lowest, middle, or highest) with cognitive performance was modified by background (e.g., Mexicans vs Cuban). CONCLUSIONS Hispanics/Latinos with higher levels of cardiovascular disease risk factor burden displayed lower levels of cognitive performance, with learning and memory performance modified by background.
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Affiliation(s)
- Melissa Lamar
- Rush Alzheimer’s Disease Center and the Department of Behavioral Sciences, Rush University Medical Center, Chicago, Illinois, United States of America
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, Illinois, United States of America
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, United States of America
| | - Ramon A. Durazo-Arvizu
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, Illinois, United States of America
- Department of Public Health Sciences, Loyola University, Chicago, Illinois, United States of America
| | - Shruti Sachdeva
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, Illinois, United States of America
| | - Amber Pirzada
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, Illinois, United States of America
| | - Krista M. Perreira
- Department of Public Policy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Tatjana Rundek
- Department of Neurology, University of Miami Health System, Miami, Florida, United States of America
| | - Linda C. Gallo
- Department of Psychology, San Diego State University, San Diego, California, United States of America
| | - Ellen Grober
- Department of Neurology, Albert Einstein College of Medicine, New York, New York, United States of America
| | - Charles DeCarli
- Department of Neurology, University of California Davis Health System, Sacramento, California, United States of America
| | - Richard B. Lipton
- Department of Neurology, Albert Einstein College of Medicine, New York, New York, United States of America
| | - Wassim Tarraf
- Institute of Gerontology, Wayne State University, Detroit, Michigan, United States of America
| | - Hector M. González
- Department of Neurosciences and Shiley-Marcos Alzheimer’s Disease Research Center, University of California San Diego, San Diego, California, United States of America
| | - Martha L. Daviglus
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, Illinois, United States of America
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, United States of America
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Gonzales MM, Durazo-Arvizu RA, Sachdeva S, Unterman TG, O'Brien MJ, Gallo LC, Talavera GA, Kaplan RC, Cai J, Schneiderman N, Espinoza Giacinto RA, González HM, Daviglus ML, Lamar M. Associations of insulin resistance with cognition in individuals without diagnosed diabetes: Results from the Hispanic Community Health Study/Study of Latinos. Diabetes Res Clin Pract 2019; 150:38-47. [PMID: 30779969 PMCID: PMC7236611 DOI: 10.1016/j.diabres.2019.01.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 12/20/2018] [Accepted: 01/30/2019] [Indexed: 01/17/2023]
Abstract
AIMS Insulin resistance (IR) adversely impacts memory and executive functioning in non-Hispanic whites without diabetes. Less is known in Hispanics/Latinos, despite the fact that Hispanics/Latinos have higher rates of insulin resistance than non-Hispanic whites. We investigated the association between IR and cognition and its variation by age. METHODS Data from 5987 participants 45-74 years old without diabetes from the Hispanic Community Health Study/Study of Latinos. IR was considered continuously using homeostasis model assessment for insulin resistance (HOMA-IR) and also dichotomized based on clinically relevant thresholds for hyperinsulinemia (fasting insulin > 84.73 pmol/L or HOMA-IR > 2.6) and sample-based norms (75th percentile of fasting insulin or HOMA-IR). Cognitive testing included the Brief Spanish English Verbal Learning Test (B-SEVLT), Verbal Fluency, and Digit Symbol Substitution. RESULTS There was 90% overlap in participant categorization comparing clinically relevant and sample-based thresholds. In separate fully-adjusted linear regression models, age modified the association between HOMA-IR and Digit Symbol Substitution (p = 0.02); advancing age combined with higher HOMA-IR levels resulted in higher scores. Age also modified the association between clinically relevant hyperinsulinemia and B-SEVLT recall (p = 0.03); with increasing age came worse performance for individuals with hyperinsulinemia. CONCLUSION The relationship of IR with cognition in Hispanics/Latinos without diabetes may reflect an age- and test-dependent state.
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Affiliation(s)
- Mitzi M Gonzales
- Department of Neurology, The University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Ramon A Durazo-Arvizu
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL, United States; Department of Biostatistics, Loyola University, Chicago, IL, United States
| | - Shruti Sachdeva
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL, United States
| | - Terry G Unterman
- Department of Medicine, University of Illinois at Chicago, Chicago, IL, United States
| | - Matthew J O'Brien
- Division of General Internal Medicine and Geriatrics, Northwestern University, Chicago, IL, United States
| | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, CA, United States
| | - Gregory A Talavera
- Division of Health Promotion and Behavioral Sciences, San Diego State University, San Diego, CA, United States
| | - Robert C Kaplan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Jianwen Cai
- Department of Biostatistics, University of North Carolina, Chapel Hill, NC, United States
| | - Neil Schneiderman
- Department of Psychology, University of Miami, Miami, FL, United States
| | - Rebeca A Espinoza Giacinto
- Department of Psychology, San Diego State University, San Diego, CA, United States; Division of Health Promotion and Behavioral Sciences, San Diego State University, San Diego, CA, United States
| | - Hector M González
- Department of Neuroscience, Shiley-Marcos Alzheimer's Disease Research Center, University of California San Diego, San Diego, CA, United States
| | - Martha L Daviglus
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL, United States; Department of Medicine, University of Illinois at Chicago, Chicago, IL, United States
| | - Melissa Lamar
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL, United States; Department of Medicine, University of Illinois at Chicago, Chicago, IL, United States; Rush Alzheimer's Disease Center and Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States.
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Scott TM, Gouse H, Joska J, Thomas KGF, Henry M, Dreyer A, Robbins RN. Home-versus acquired-language test performance on the Hopkins Verbal Learning Test-Revised among multilingual South Africans. APPLIED NEUROPSYCHOLOGY-ADULT 2018; 27:173-180. [PMID: 30265567 DOI: 10.1080/23279095.2018.1510403] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The Hopkins Verbal Learning Test-Revised (HVLT-R) has been adapted for use in many different languages and in low- and middle-income countries. However, few adaptations have evaluated performance differences between home- and acquired-language administrations. The present study examined performance on an adapted HVLT-R between multilingual South Africans who chose to be tested in a home or acquired language. The HVLT-R was administered to 112 multilingual, isiXhosa as home language, Black South African adults (49% men) with no major medical, neurological, or psychiatric problems. Sixty-one preferred to take the test in isiXhosa and 51 preferred English. We examined between-language differences in word equivalency, primary scores, learning indices, and serial position effects. We also examined language, age, education, and gender on test performance. English-examinees were significantly younger and more educated than isiXhosa-examinees (p's < .05). Although isiXhosa words had more letters and syllables than English words (p's <.001), there were no significant differences between groups on HVLT-R performance or serial recall (p's > .05). More education and being a woman predicted better Total and Delayed Recall (p's<.05). Performance on this modified HVLT-R appears similar between English and isiXhosa administrations among South African isiXhosa first language speakers, which makes comparisons between preferred language administrations appropriate.
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Affiliation(s)
- Travis M Scott
- Department of Psychology, Fordham University, Bronx, New York, USA.,HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, New York, USA
| | - Hetta Gouse
- HIV Mental Health Research Unit, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - John Joska
- HIV Mental Health Research Unit, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Kevin G F Thomas
- ASCENT Laboratory, Department of Psychology, University of Cape Town, Cape Town, South Africa
| | - Michelle Henry
- Centre for Higher Education Development, University of Cape Town, Cape Town, South Africa
| | - Anna Dreyer
- HIV Mental Health Research Unit, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Reuben N Robbins
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, New York, USA
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González HM, Tarraf W, Vásquez P, Sanderlin AH, Rosenberg NI, Davis S, Rodríguez CJ, Gallo LC, Thyagarajan B, Daviglus M, Khambaty T, Cai J, Schneiderman N. Metabolic Syndrome and Neurocognition Among Diverse Middle-Aged and Older Hispanics/Latinos: HCHS/SOL Results. Diabetes Care 2018; 41:1501-1509. [PMID: 29716895 PMCID: PMC6014545 DOI: 10.2337/dc17-1896] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 04/07/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Hispanics/Latinos have the highest risks for metabolic syndrome (MetS) in the U.S. and are also at increased risk for Alzheimer disease. In this study, we examined associations among neurocognitive function, MetS, and inflammation among diverse middle-aged and older Hispanics/Latinos. RESEARCH DESIGN AND METHODS Cross-sectional data (2008-2011) from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) were analyzed to examine associations between neurocognition and MetS among diverse Hispanics/Latinos (N = 9,136; aged 45-74 years). RESULTS MetS status was associated with lower global neurocognition, mental status, verbal learning and memory, verbal fluency, and executive function. Age significantly modified the associations between MetS and learning and memory measures. Significant associations between MetS and neurocognition were observed among middle-aged Hispanics/Latinos, and all associations remained robust to additional covariates adjustment. CONCLUSIONS We found that MetS was associated with lower neurocognitive function, particularly in midlife. Our findings support and extend current hypotheses that midlife may be a particularly vulnerable developmental period for unhealthy neurocognitive aging.
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Affiliation(s)
- Hector M González
- Department of Neurosciences and Shiley-Marcos Alzheimer's Disease Research Center, University of California, San Diego, La Jolla, CA
| | - Wassim Tarraf
- Institute of Gerontology and Department of Healthcare Sciences, Wayne State University, Detroit, MI
| | - Priscilla Vásquez
- Department of Neurosciences and Shiley-Marcos Alzheimer's Disease Research Center, University of California, San Diego, La Jolla, CA
| | - Ashley H Sanderlin
- Section of Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Natalya I Rosenberg
- Institute for Minority Health Research, College of Medicine, University of Illinois at Chicago, Chicago, IL
| | - Sonia Davis
- Collaborative Studies Coordinating Center, Department of Biostatistics, The University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Carlos J Rodríguez
- Departments of Medicine and Epidemiology, Wake Forest School of Medicine, Winston-Salem, NC
| | - Linda C Gallo
- Institute for Behavioral and Community Health and Graduate School of Public Health, San Diego State University, San Diego, CA
| | - Bharat Thyagarajan
- Department of Laboratory Medicine and Pathology, University of Minnesota Medical Center Fairview, Minneapolis, MN
| | - Martha Daviglus
- Institute for Minority Health Research, College of Medicine, University of Illinois at Chicago, Chicago, IL
| | - Tasneem Khambaty
- Department of Psychology, University of Maryland, Baltimore County, Baltimore, MD
| | - Jianwen Cai
- Collaborative Studies Coordinating Center, Department of Biostatistics, The University of North Carolina at Chapel Hill, Chapel Hill, NC
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Association of Cardiac Structure and Function With Neurocognition in Hispanics/Latinos: The Echocardiographic Study of Latinos. Mayo Clin Proc Innov Qual Outcomes 2018; 2:165-175. [PMID: 30225446 PMCID: PMC6124325 DOI: 10.1016/j.mayocpiqo.2018.02.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Objective To study the associations of comprehensive measures of cardiac structure and function with multidimensional neurocognitive measures. Patients and Methods The Echocardiographic Study of Latinos is a population-based cohort of Hispanic/Latino adults older than 45 years enrolled from October 1, 2011, through June 30, 2014. Neurocognitive measures included Word Fluency (WF), Brief-Spanish English Verbal Learning Test (B-SEVLT), and Digit Symbol Substitution Test. The B-SEVLT included B-SEVLT-recall and B-SEVLT-sum. Echocardiographic measures included cardiac structure, systolic and diastolic function, and myocardial strain. Multivariable regression models were fit using survey statistics and sampling probabilities. Results A total of 1794 participants (mean age, 56±0.5 years; 56% women) were included in the analysis. In the adjusted model, higher left ventricular mass index was associated with lower B-SEVLT-sum and Digit Symbol Substitution Test scores. Left ventricular systolic dysfunction was associated with lower WF scores. Abnormal left ventricular geometry was associated with lower B-SEVLT-sum scores. Higher relative wall thickness was associated with B-SEVLT-recall and B-SEVLT-sum scores. Mitral annular relaxation velocities were associated with lower B-SEVLT-recall, B-SEVLT-sum, and WF scores. Higher mitral inflow to annular early diastolic velocity ratio was associated with lower B-SEVLT-recall and B-SEVLT-sum scores. Diastolic dysfunction was associated with lower B-SEVLT-sum scores. Finally, lower global longitudinal strain was associated with lower WF scores. Conclusion Alterations in cardiac structure, systolic and diastolic function, and myocardial strain were associated with worse neurocognitive function. Further study is needed to determine the mechanisms (ie, impairment of cerebral flow and silent brain infarctions) mediating these heart-brain associations.
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Key Words
- B-SEVLT, Brief-Spanish English Verbal Learning Test
- BMI, body mass index
- CVH, cardiovascular health
- DSST, Digit Symbol Substitution Test
- E/e′ ratio, ratio of the early mitral inflow velocity to the mitral annular early diastolic velocity
- ECHO-SOL, Echocardiographic Study of Latinos
- EF, ejection fraction
- GLS, global longitudinal strain
- HCHS/SOL, Hispanic Community Health Study/Study of Latinos
- LA, left atrial
- LAVI, left atrial volume index
- LV, left ventricular
- LVESV, left ventricular end-systolic volume
- LVMI, left ventricular mass index
- RWT, relative wall thickness
- SIS, Six-Item Screener
- S′, peak systolic annular velocity
- WF, Word Fluency
- e′, mitral annular early diastolic velocity
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Tarraf W, Rodríguez CJ, Daviglus ML, Lamar M, Schneiderman N, Gallo L, Talavera GA, Kaplan RC, Fornage M, Conceicao A, González HM. Blood Pressure and Hispanic/Latino Cognitive Function: Hispanic Community Health Study/Study of Latinos Results. J Alzheimers Dis 2018; 59:31-42. [PMID: 28582859 DOI: 10.3233/jad-170017] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND Hispanics/Latinos are at increased risk for cardiovascular disease and cognitive decline and dementias. High blood pressure (BP) has been implicated in both stroke and dementias. Associations between BP and cognition among diverse Latinos are still unpublished. OBJECTIVE We examined associations between cognition and four BP based measures among diverse Hispanics/Latinos. We hypothesized that higher BP, particularly systolic pressure, and increased arterial stiffness (i.e., pulse pressure), would be associated with lower cognitive function. METHODS We used baseline (2008-2011) Hispanic Community Health Study/Study of Latinos (HCHS/SOL; n = 9,019; ages 45-74 years) data to examine cognition in relation to BP measures. RESULTS In age, sex, and education adjusted models, systolic, pulse, and mean arterial pressure were consistently negatively associated with executive function, psychomotor speed and sustained attention, verbal episodic learning and memory, speech fluency, and mental status measures. These associations were attenuated but remained statistically significant in fully adjusted models. CONCLUSION Among middle-aged and older diverse Hispanics/Latinos, we found modest but consistent associations between indicators of arterial stiffness, and compromised blood flow and lower cognitive function. Clinical management and public health interventions to raise awareness and enhance BP management beginning in midlife could reduce disparities and improve population health by reducing cognitive decline burdens.
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Affiliation(s)
- Wassim Tarraf
- Department of Healthcare Sciences and Wayne State University, Institute of Gerontology, Detroit, MI, USA
| | - Carlos J Rodríguez
- Department of Medicine and Department of Epidemiology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Martha L Daviglus
- University of Illinois at Chicago, Institute for Minority Health Research, College of Medicine at Chicago, Chicago, IL, USA
| | - Melissa Lamar
- University of Illinois at Chicago, Institute for Minority Health Research, College of Medicine at Chicago, Chicago, IL, USA.,Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - Neil Schneiderman
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Linda Gallo
- San Diego State University, Institute for Behavioral and Community Health, Graduate School of Public Health, San Diego, CA, USA
| | - Gregory A Talavera
- San Diego State University, Institute for Behavioral and Community Health, Graduate School of Public Health, San Diego, CA, USA
| | - Robert C Kaplan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, New York, NY, USA
| | - Myriam Fornage
- University of Texas Health Science Center, Institute of Molecular Medicine and Human Genetics Center, San Antonio, TX, USA
| | - Alan Conceicao
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA
| | - Hector M González
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA
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