62 research outputs found
Cardiovascular Risk Score, Cognitive Decline, and Dementia in Older Mexican Americans: The Role of Sex and Education
Background: The purpose of this study was to examine the associations of cardiovascular disease (CVD) risk with cognitive decline and incidence of dementia and cognitive impairment but not dementia (CIND) and the role of education as a modifier of these effects. Methods and Results: One thousand one hundred sixteen Mexican American elderly were followed annually in the Sacramento Area Latino Study on Aging. Our sex‐specific 10‐year CVD risk score included baseline age, systolic blood pressure, total cholesterol, high‐density lipoprotein, smoking, body mass index, and diabetes. From adjusted linear mixed models, errors on the Modified Mini–Mental State Exam (3MSE) were annually 0.41% lower for women at the 25th percentile of CVD risk, 0.11% higher at the 50th percentile, and 0.83% higher at the 75th percentile (P value of CVDrisk×time <0.01). In men, 3MSE errors were annually 1.76% lower at the 25th percentile of CVD risk, 0.96% lower at the 50th percentile, and 0.12% higher at the 75th percentile (P value of CVDrisk×time <0.01). From adjusted linear mixed models, the annual decrease in the Spanish and English Verbal Learning Test score was 0.09 points for women at the 25th percentile of CVD risk, 0.10 points at the 50th percentile, and 0.12 points at the 75th percentile (P value of CVDrisk×time=0.02). From adjusted Cox models in women, compared with having <6 years of education, having 12+ years of education was associated with a 76% lower hazard of dementia/CIND (95% CI, 0.08 to 0.71) at the 25th percentile of CVD risk and with a 45% lower hazard (95% CI, 0.28 to 1.07) at the 75th percentile (P value of CVDrisk×education=0.05). Conclusions: CVD risk score may provide a useful tool for identifying individuals at risk for cognitive decline and dementia
The association of parental and offspring educational attainment with systolic blood pressure, fasting blood glucose and waist circumference in Latino adults
Objective: The objective of the study is to evaluate the association of intergenerational educational attainment with cardiovascular disease (CVD) risk factors among US Latinos. Methods: We used cross-sectional data from the Niños Lifestyle and Diabetes Study, an offspring cohort of middle-aged Mexican-Americans whose parents participated in the Sacramento Latino Study on Aging. We collected educational attainment, demographic and health behaviours and measured systolic blood pressure (SBP), fasting glucose and waist circumference. We evaluated the association of parental, offspring and a combined parent–offspring education variable with each CVD risk factor using multivariable regression. Results: Higher parental education was associated only with smaller offspring waist circumference. In contrast, higher offspring education was associated with lower SBP, fasting glucose and smaller waist circumference. Adjustment for parental health behaviours modestly attenuated these offspring associations, whereas adjustment for offspring health behaviours and income attenuated the associations of offspring education with offspring SBP and fasting glucose but not smaller waist circumference, even among offspring with low parental education. Conclusions: Higher offspring education is associated with lower levels of CVD risk factors in adulthood, despite intergenerational exposure to low parental education
Relation of Diabetes to Cognitive Function in Hispanics/Latinos of Diverse Backgrounds in the United States
Objectives:To examine the association between diabetes and cognitive function within U.S. Hispanics/Latinos of Central American, Cuban, Dominican, Mexican, Puerto Rican, and South American background. Method: This cross-sectional study included 9,609 men and women (mean age = 56.5 years), who are members of the Hispanic Community Health Study/Study of Latinos. We classified participants as having diabetes, prediabetes, or normal glucose regulation. Participants underwent a neurocognitive battery consisting of tests of verbal fluency, delayed recall, and processing speed. Analyses were stratified by Hispanic/Latino subgroup. Results: From fully adjusted linear regression models, compared with having normal glucose regulation, having diabetes was associated with worse processing speed among Cubans (β = −1.99; 95% CI [confidence interval] = [−3.80, −0.19]) and Mexicans (β = −2.26; 95% CI = [−4.02, −0.51]). Compared with having normal glucose regulation, having prediabetes or diabetes was associated with worse delayed recall only among Mexicans (prediabetes: β = −0.34; 95% CI = [−0.63, −0.05] and diabetes: β = −0.41; 95% CI = [−0.79, −0.04]). No associations with verbal fluency. Discussion: The relationship between diabetes and cognitive function varied across Hispanic/Latino subgroup
Trajectories of dementia-related cognitive decline in a large mental health records derived patient cohort
Background: Modeling trajectories of decline can help describe the variability in progression of cognitive impairment in dementia. Better characterisation of these trajectories has significant implications for understanding disease progression, trial design and care planning. Methods: Patients with at least three Mini-mental State Examination (MMSE) scores recorded in the South London and Maudsley NHS Foundation Trust Electronic Health Records, UK were selected (N = 3441) to form a retrospective cohort. Trajectories of cognitive decline were identified through latent class growth analysis of longitudinal MMSE scores. Demographics, Health of Nation Outcome Scales and medications were compared across trajectories identified. Results: Four of the six trajectories showed increased rate of decline with lower baseline MMSE. Two trajectories had similar initial MMSE scores but different rates of decline. In the faster declining trajectory of the two, a higher incidence of both behavioral problems and sertraline prescription were present. Conclusions: We find suggestive evidence for association of behavioral problems and sertraline prescription with rate of decline. Further work is needed to determine whether trajectories replicate in other datasets
Central Obesity, Leptin and Cognitive Decline: The Sacramento Area Latino Study on Aging
BACKGROUND/AIMS: Central obesity is a risk factor for cognitive decline. Leptin is secreted by adipose tissue and has been associated with better cognitive function. Aging Mexican-Americans have higher levels of obesity than Non-Hispanic Whites, but no investigations examined the relationship between leptin and cognitive decline among them or the role of central obesity in this association. METHODS: We analyzed 1480 dementia-free older Mexican-Americans who were followed over ten years. Cognitive function was assessed every 12 to 15 months with the Modified Mini Mental State Exam (3MSE) and the Spanish and English Verbal Learning Test (SEVLT). RESULTS: For females with small waist circumference (≤35inches), an interquartile range (IQR) difference in leptin was associated with 35% less 3MSE errors and 22% less decline in SEVLT score over 10 years. For males with small waist circumference (≤40inches), an IQR difference in leptin was associated with 44% less 3MSE errors and 30% less decline in SEVLT score over 10 years. There was no association between leptin and cognitive decline among females or males with large waist circumference. CONCLUSION: Leptin interacts with central obesity in shaping cognitive decline. Our findings provide valuable information about the effects of metabolic risk factors on cognitive function
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Abstract P013: Associations Between Diastolic Blood Pressure With Cognitive Functioning: Differences By Systolic Blood Pressure Among US Adults
Introduction:
While elevated systolic blood pressure (BP) is a known contributor to cognitive decline, the role of elevated diastolic BP (DBP) as an independent risk factor for cognitive decline is less clear, especially in relationship to systolic BP (SBP) levels.
Objectives:
To characterize the association between DBP and cognitive functioning at differing levels of SBP.
Methods:
The National Health and Nutrition Examination Survey is a nationally representative survey of U.S. adults conducted annually. Our sample included data from participants of the 1999-2002 and 2011-2014 cycles, age 60+, with measured BP and cognition (N=5,480). BP was measured three times manually with a standardized sphygmomanometer and averaged. Cognitive functioning was measured using the digit symbol substitution test (DSST), a measure of executive functioning (with higher scores indicating better performance: range 0-100). We tested for a statistical interaction between SBP and DBP. To determine whether DBP was associated with DSST score, we used linear regression analyses and stratified by categories of SBP. Models were adjusted for: age, sex, race, education, income, insurance, marital status, BMI, diabetes, BP medication, and cholesterol. All analyses accounted for the complex survey design.
Results:
Almost half (48.9%, SE=1.1) of the sample was aged 60-69 with 55.3% (SE=0.7) female. The association between DBP and cognitive functioning differed by SBP (p<0.01), leading to stratified analyses. Every 5 mmHg increment of DBP was associated with significantly higher DSST scores among individuals with SBP 110-119 mmHg only (beta: 0.76, 95% CI: 0.24, 1.27). Results were not significant among participants with SBP < 110mmHg (beta: 0.84, 95% CI: -0.09, 1.77), SBP 120-129 mmHg (beta: 0.09, 95% CI:-0.49, 0.69), SBP 130-140 mmHg (beta: 0.29, 95% CI: -0.10, 0.69), SBP 140-159 mmHg (beta: 0.23, 95% CI: -0.15, 0.61), or SBP ≥160mmHg (beta: -0.08, 95% CI: -0.56, 0.39).
Conclusion:
In a population-based sample of older US adults, higher DBP was associated with greater executive functioning only among individuals with normal SBP. The results suggest that at non-hypertensive levels of SBP, higher DBP may not be detrimental for cognitive performance
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Association between chronic kidney disease detected using creatinine and cystatin C and death and cardiovascular events in elderly Mexican Americans: the Sacramento Area Latino Study on Aging.
ObjectivesCreatinine, the current clinical standard to detect chronic kidney disease (CKD), is biased by muscle mass, age and race. The authors sought to determine whether cystatin C, an alternative marker of kidney function less biased by these factors, can identify elderly Mexican Americans with CKD who are at high risk for death and cardiovascular disease.DesignLongitudinal, with mean follow-up of 6.8 years.SettingSacramento Area Latino Study of Aging (SALSA).ParticipantsOne thousand four hundred and thirty five Mexican Americans aged 60 to 101.MeasurementsEstimated glomerular filtration rate (eGFR, mL/min per 1.73 m(2)) was determined according to creatinine (eGFRcreat) and cystatin C (eGFRcys), and participants were classified into four mutually exclusive categories: CKD neither (eGFRcreat ≥60 mL/min per 1.73 m(2); eGFRcys ≥60 mL/min per 1.73 m(2)), CKD creatinine only (eGFRcreat <60 mL/min per 1.73 m(2); eGFRcys ≥60 mL/min per 1.73 m(2)), CKD cystatin only (eGFRcreat ≥60 mL/min per 1.73 m(2); eGFRcys <60), and CKD both (eGFRcreat <60 mL/min per 1.73 m(2); GFRcys <60 mL/min per 1.73 m(2)). The associations between each CKD classification and all-cause death and cardiovascular (CV) death were studied using Cox regression.ResultsAt baseline, mean age was 71 ± 7; 481 (34%) had diabetes mellitus, and 980 (68%) had hypertension. Persons with CKD both had higher risk for all-cause (HR = 2.30, 95% confidence interval (CI) = 1.78-2.98) and CV disease (CVD) (HR = 2.75, 95% CI = 1.96-3.86) death than CKD neither after full adjustment. Persons with CKD cystatin C only were also at greater risk of all-cause (HR = 1.91, 95% CI = 1.37-2.67) and CV (HR = 2.56, 95% CI = 1.64-3.99) death than CKD neither. In contrast, persons with CKD creatinine only were not at greater risk for CV death (HR = 1.39, 95% CI = 0.71-2.72) but were at higher risk for all-cause death (HR = 1.95, 95% CI = 1.27-2.98).ConclusionCystatin C may be a useful alternative to creatinine for detecting high risk of death and CVD in elderly Mexican Americans with CKD
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