Population Attributable Fraction for Cognitive Impairment in Mexican American Older Adults.

IF 2.4 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Journal of Racial and Ethnic Health Disparities Pub Date : 2025-10-13 DOI:10.1007/s40615-025-02687-0

Mellanie V Springer, Wen Chang, Steven G Heeringa, Emily M Briceño, Roshanak Mehdipanah, Xavier F Gonzales, Nicholas Hartman, Deborah A Levine, Kenneth M Langa, Darin B Zahuranec, Nelda Garcia, Lewis B Morgenstern

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Abstract

Background: The contribution of modifiable risk factors to cases of mild cognitive impairment (MCI) and Alzheimer's disease and related dementias (AD/ADRD) among Hispanic/Latin (a,o,x) adults is unclear.

Objective: To determine the population attributable fraction (PAF), the proportion of MCI and AD/ADRD cases that would be eliminated with elimination of modifiable risk factors.

Methods: This was a cross-sectional analysis nested within a prospective cohort study (2018 - 2023) of Mexican American older adults. Logistic regression estimated the odds of probable MCI or AD/ADRD (defined by education-specific cutoff scores on the Montreal Cognitive Assessment) associated with age, sex, education, medical comorbidities, cigarette smoking, and alcohol consumption. We calculated the PAF for MCI and AD/ADRD associated with individual and combined risk factors.

Results: Among 1,272 participants, the prevalence of MCI was 48% and of AD/ADRD was 23%. Having no more than a high school education was associated with a PAF for MCI of 17% (95% CI, 10 - 24%) and a PAF for AD/ADRD of 52% (95% CI, 40 - 64%). Heart disease and diabetes were each associated with a PAF for MCI of 5% (95% CI, 3 - 7% and 95% CI, 1 - 10% respectively). A history of stroke was associated with a PAF for AD/ADRD of 7% (95% CI, 3 - 11%). The elimination of all modifiable risk factors was associated with 28% of MCI and 55% of AD/ADRD cases.

Discussion: Low educational attainment and cardiovascular comorbidities greatly contribute to cases of MCI and AD/ADRD among Mexican American adults.

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墨西哥裔美国老年人认知障碍的人群归因比例。

背景：西班牙裔/拉丁裔（a,o,x）成年人轻度认知障碍（MCI）和阿尔茨海默病及相关痴呆（AD/ADRD）的可改变危险因素的贡献尚不清楚。目的：确定人群归因分数（PAF）， MCI和AD/ADRD病例的比例，消除可改变的危险因素。方法：这是一项针对墨西哥裔美国老年人的前瞻性队列研究（2018 - 2023）的横断面分析。Logistic回归估计MCI或AD/ADRD（由蒙特利尔认知评估中特定教育程度的临界值定义）的可能性与年龄、性别、教育程度、医疗合并症、吸烟和饮酒相关。我们计算了MCI和AD/ADRD与个体和综合危险因素相关的PAF。结果：在1272名参与者中，MCI患病率为48%，AD/ADRD患病率为23%。高中以下学历与MCI的PAF相关性为17% (95% CI, 10 - 24%)， AD/ADRD的PAF相关性为52% （95% CI, 40 - 64%）。心脏病和糖尿病与MCI的PAF各相关5% （95% CI分别为3 - 7%和95% CI分别为1 - 10%）。卒中史与AD/ADRD的PAF相关性为7% （95% CI, 3 - 11%）。消除所有可改变的危险因素与28%的MCI和55%的AD/ADRD病例相关。讨论：在墨西哥裔美国成年人中，低教育程度和心血管合并症是MCI和AD/ADRD的主要原因。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Racial and Ethnic Health Disparities PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

7.30

自引率

5.10%

发文量

263

期刊介绍： Journal of Racial and Ethnic Health Disparities reports on the scholarly progress of work to understand, address, and ultimately eliminate health disparities based on race and ethnicity. Efforts to explore underlying causes of health disparities and to describe interventions that have been undertaken to address racial and ethnic health disparities are featured. Promising studies that are ongoing or studies that have longer term data are welcome, as are studies that serve as lessons for best practices in eliminating health disparities. Original research, systematic reviews, and commentaries presenting the state-of-the-art thinking on problems centered on health disparities will be considered for publication. We particularly encourage review articles that generate innovative and testable ideas, and constructive discussions and/or critiques of health disparities.Because the Journal of Racial and Ethnic Health Disparities receives a large number of submissions, about 30% of submissions to the Journal are sent out for full peer review.