Neuroimaging markers of dementia across race/ethnicity and sex/gender using an intersectional approach within the HABS-HD cohort

INTRODUCTION

Racial/ethnic and sex/gender differences in neuroimaging markers of dementia have been previously explored, but rarely with an intersectional approach.

METHODS

Using data from the Health and Aging Brain Study–Health Disparities cohort, we examined neuroimaging markers of dementia using both interaction between race/ethnicity and sex/gender and effect modification of race/ethnicity by sex/gender.

RESULTS

We analyzed data from 3433 dementia-free participants with either magnetic resonance imaging or positron emission tomography (PET) data at baseline (mean [standard deviation] age: 65 [9] years, 36% non-Hispanic White [NHW], 27% Black, 37% Hispanic, and 63% women). Compared to NHW, Black men had lower global amyloid PET standardized uptake value ratio (SUVR; β [95% confidence interval]: –0.32 [–0.53, –0.11]), and Hispanic (0.65 [0.39, 0.91]) and Black women had greater medial temporal lobe tau SUVR (0.49 [0.30, 0.69]).

DISCUSSION

We observed that the distribution of neuroimaging markers of dementia differed across racial/ethnicity groups by sex/gender. An intersectional approach can aid in tailoring research and clinical efforts in preventing and treating dementia.

Highlights

• Hispanic and Black women had greater medial temporal lobe tau deposition, compared to their non-Hispanic White counterparts.
• Black men had lower global amyloid deposition compared to non-Hispanic White men.
• Black men and women had higher burden of cerebral small vessel disease compared to their non-Hispanic White counterparts, with stronger associations in Black men.