UNASSIGNED: Using a pooled cohort of 4,159 White and 939 Black participants aged 65-95 years, we conducted a mediation analysis to estimate the proportional effect of race on dementia that is explained by four CVRFs imputed over the life course (20-49, 50-69, and 70-89 years of age): body mass index, fasting glucose, systolic blood pressure, and low-density lipoprotein cholesterol.
UNASSIGNED: Compared to White participants, Black participants had greater risk of dementia (adjusted OR = 1.37; 95% CI: 1.17-1.60). BMI and fasting glucose over the life course were significant mediators of the effect of race on dementia risk, mediating 39.1% (95% CI: 10.5-67.8%) and 8.2% (95% CI: 0.1-16.2%) of the effect, adjusted for sex and age. All four CVRFs together were also significant mediators of the effect of race on scores on global cognition and processing speed, accounting for approximately 11% of the effect.
UNASSIGNED: We found that CVRFs across the life course partially explain disparities in dementia risk and cognition in late-life. Improved prevention and treatment of CVRFs across the life course may be important to reduce health disparities for dementia.
■使用4,159名65-95岁的白人和939名黑人参与者的合并队列,我们进行了调解分析,以估计种族对痴呆症的比例影响,这可以通过在一生中估算的四个CVRF(20-49、50-69和70-89岁)来解释:体重指数,空腹血糖,收缩压,和低密度脂蛋白胆固醇.
■与白人参与者相比,黑人参与者患痴呆症的风险更高(校正后OR=1.37;95%CI:1.17-1.60)。生命过程中的BMI和空腹血糖是种族对痴呆风险影响的重要媒介,介导39.1%(95%CI:10.5-67.8%)和8.2%(95%CI:0.1-16.2%)的效应,根据性别和年龄进行调整。所有四个CVRF都是种族对全球认知和处理速度的影响的重要媒介,约占效果的11%。
■我们发现生命过程中的CVRF部分解释了晚年痴呆风险和认知的差异。在整个生命过程中改善CVRF的预防和治疗对于减少痴呆症的健康差异可能很重要。