PDF(Pubmed)
Abstract：
UNASSIGNED: Racial disparities in dementia outcomes persist in the United States. Targeting modifiable risk factors, including cardiovascular risk factors (CVRFs), is a conceivable way to reduce health disparities. Life course CVRFs are often higher in non-White adults and are associated with risk of dementia, but it is unknown whether they contribute to racial disparities in dementia and cognition.
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.
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.
摘要：
■在美国，痴呆症结局的种族差异仍然存在。针对可修改的风险因素，包括心血管危险因素（CVRF），是减少健康差距的一种可以想象的方法。非白人成年人的生命历程CVRF通常较高，并且与痴呆症的风险有关。但尚不清楚它们是否会导致痴呆症和认知方面的种族差异。
■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。
■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。
