A Community-Based Study of Dementia in Mexican American and Non-Hispanic White Individuals

Article type: Research Article

Authors: Morgenstern, Lewis B.^{a; b; *} | Briceño, Emily M.^{a; c} | Mehdipanah, Roshanak^d | Chang, Wen^e | Lewandowski-Romps, Lisa^e | Gonzales, Xavier F.^f | Levine, Deborah A.^{a; g} | Langa, Kenneth M.^{e; g; h} | Garcia, Nelda^a | Khan, Noreen^a | Zahuranec, Darin B.^a | Heeringa, Steven G.^e

Affiliations: [a] Department of Neurology, University of Michigan Medical School, Ann Arbor, MI, USA | [b] Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, Ann Arbor, MI, USA | [c] Department of Physical Medicine & Rehabilitation, University of Michigan Medical School, Ann Arbor, MI, USA | [d] Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA | [e] University of Michigan Institute for Social Research, Ann Arbor, MI, USA | [f] Department of Life Sciences, Texas A&M University-Corpus Christi, Corpus Christi, TX, USA | [g] Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA | [h] Veterans Affairs Ann Arbor Center for Clinical Management Research, Ann Arbor, MI, USA

Correspondence: [*] Correspondence to: Lewis B. Morgenstern, MD, Department of Epidemiology, University of Michigan, 1415 Washington Heights, SPH I Room 2659, Ann Arbor, MI 48109, USA. E-mail: [email protected].

Abstract: Background: Little information is available on the prevalence of cognitive impairment in Mexican American persons. Objective: To determine the prevalence of mild cognitive impairment (MCI) and dementia in those 65 years and older among Mexican American and non-Hispanic white individuals in a community. Methods: This was a population-based cohort study in Nueces County, Texas, USA. Participants were recruited using a random housing sample. The Harmonized Cognitive Assessment (HCAP) participant and informant protocol was performed after Montreal Cognitive Assessment (MoCA) screening. An algorithm was used to sort participants into diagnostic categories: no cognitive impairment, MCI, or dementia. Logistic regression determined the association of ethnicity with MCI and dementia controlling for age, gender, and education. Results: 1,901 participants completed the MoCA and 547 the HCAP. Mexican Americans were younger and had less educational attainment than non-Hispanic whites. Overall, dementia prevalence was 11.6% (95% CI 9.2–14.0) and MCI prevalence was 21.2% (95% CI 17.5–24.8). After adjusting for age, gender, and education level, there was no significant ethnic difference in the odds of dementia or MCI. Those with ≤11 compared with ≥16 years of education had much higher dementia [OR = 4.9 (95% CI 2.2–11.1)] and MCI risk [OR = 3.5 (95% CI 1.6–7.5)]. Conclusions: Dementia and MCI prevalence were high in both Mexican American and non-Hispanic white populations. Mexican American persons had double the odds of mild cognitive impairment and this was attenuated when age and educational attainment were considered. Educational attainment was a potent predictor of cognitive impairment.

Keywords: Alzheimer’s disease, community, dementia, disparities, education, epidemiology, health equity, Hispanic, Mexican American, mild cognitive impairment

DOI: 10.3233/JAD-230729

Journal: Journal of Alzheimer's Disease, vol. 97, no. 2, pp. 649-658, 2024