Racial/ethnic disparities in young adulthood and midlife cardiovascular risk factors and late-life cognitive domains the Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE) Study

Rachel L. Peterson, Kristen M. George, Paola Gilsanz, Sarah Ackley, Elizabeth R. Mayeda, M. M. Glymour, Dan M. Mungas, Charles DeCarli, Rachel A. Whitmer

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Midlife cardiovascular risk factors (CVRF) increase dementia risk. Less is known about whether CVRF identified before midlife impact late-life cognition in diverse populations. Methods: Linear regression models examined hypertension, hyperlipidemia, and overweight/obesity at ages 30 to 59 with late-life executive function, semantic memory, verbal episodic memory, and global cognition in a cohort of Asians, blacks, Latinos, and whites (n = 1127; mean age = 75.8, range = 65 to 98). Models adjusted for age at CVRF, age at cognitive assessment, sex, race/ethnicity, participant education, and parental education. Results: Overall, 34% had 1 CVRF at ages 30 to 59; 19% had 2+. Blacks (26%) and Latinos (23%) were more likely to have 2+ CVRF than Asians (14%) or whites (13%). Having 2+ CVRF was associated with lower global cognition [β = −0.33; 95% confidence interval (CI) = −0.45, −0.21], executive function (β = −0.26; 95% CI = −0.39, −0.13), verbal episodic memory (β = −0.34; 95% CI = −0.48, −0.20), and semantic memory (β = −0.20; 95% CI = −0.33, −0.07). Interaction by age (P = 0.06) indicated overweight/obesity was negatively associated with executive function at ages 30 to 39 but not at ages 40 to 59. Race/ethnic-specific effects showed disparities in CVRF prevalence impact population disparities in late-life cognition. Conclusion: Being overweight/obese in early adulthood and having 2+ CVRF in early adulthood/midlife are modifiable targets to redress racial/ethnic disparities in cognitive impairment and dementia.

Original languageEnglish
Pages (from-to)99-105
Number of pages7
JournalAlzheimer Disease and Associated Disorders
Volume35
Issue number2
DOIs
StatePublished - 2021

Keywords

  • Cardiovascular risk factors
  • Cohort
  • Disparities
  • Epidemiology
  • Life course

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