■文化适应影响认知障碍和痴呆发作的机制尚不清楚。尤其是年长的西班牙裔。
■研究炎症和心理行为因素是否在老年墨西哥裔美国人中介导文化适应和痴呆之间的关系。
■我们分析了萨克拉曼多地区拉丁裔老龄化研究(1998-2007,SALSA),一项纵向研究(N=1,194),随访10年,并使用g计算进行调解分析,并进行汇总逻辑回归,以评估文化适应(通过墨西哥裔美国人修订的文化适应评定量表[ARSMA-II]评估)是否通过炎症影响痴呆症或认知障碍,但不影响痴呆症(CIND)(即,白细胞介素6[IL-6],肿瘤坏死因子-α(TNF-α),高敏C反应蛋白[hs-CRP]),吸烟,酒精消费,和抑郁症状。在基线时评估潜在的介质。
■美国高文化适应和痴呆/CIND影响的10年平均调整风险比(aRR)为0.66,95%CI(0.36,1.30)。间接影响是:IL-6(aRR=0.98,95%CI(0.88,1.05));TNF-α(aRR:0.99,95%CI(0.93,1.05));hs-CRP:(aRR=1.21,95%CI(0.84,1.95));当前吸烟:aRR=0.97,95%CI(0.84,1.16);每日/每周酒精消费(=1.96%RRhs-CRP的介导比例为-26%,提示hs-CRP可以抑制美国高适应的潜在效应。探索的其他因素几乎没有调解。
■文化适应对痴呆/CIND发病时间的影响随时间变化。我们的研究表明,炎症可以抑制高美国文化程度和痴呆风险之间的影响。
UNASSIGNED: The mechanisms through which
acculturation influences the onset of cognitive impairment and dementia are not well understood, especially among older Hispanics.
UNASSIGNED: To investigate whether inflammation and psycho-behavioral factors mediate the relationship between
acculturation and incident dementia among older Mexican Americans.
UNASSIGNED: We analyzed the Sacramento Area Latino Study on Aging (1998-2007, SALSA), a longitudinal study (N = 1,194) with 10 years of follow-up, and used g-computation for mediation analysis with pooled logistic regression to evaluate whether acculturation (assessed by the Revised
Acculturation Rating Scale for Mexican Americans [ARSMA-II]) affected dementia or cognitive impairment but not dementia (CIND) through inflammation (i.e., interleukin 6 [IL-6], tumor necrosis factor-α (TNF-α), high-sensitivity C-reactive protein [hs-CRP]), smoking, alcohol consumption, and depressive symptoms. The potential mediators were assessed at baseline.
UNASSIGNED: The 10-year average adjusted risk ratio (aRR) for the effect of high U.S. acculturation and dementia/CIND was 0.66, 95% CI (0.36, 1.30). The indirect effects were: IL-6 (aRR = 0.98, 95% CI (0.88, 1.05)); TNF-α (aRR:0.99, 95% CI (0.93, 1.05)); hs-CRP: (aRR = 1.21, 95% CI (0.84, 1.95)); current smoking: aRR = 0.97, 95% CI (0.84, 1.16); daily/weekly alcohol consumption (aRR = 1.00, 95% CI (0.96, 1.05)); and depressive symptom score (aRR = 1.03, 95% CI (0.95, 1.26)). hs-CRP yielded a proportion mediated of -26%, suggesting that hs-CRP could suppress the potential effect of high U.S. acculturation. The other factors explored resulted in little to no mediation.
UNASSIGNED: The effect of
acculturation on time to incident dementia/CIND varied over time. Our study suggests that inflammation could suppress the effect between high U.S.
acculturation and dementia risk.