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Association between enrollment factors and incident cognitive impairment in Blacks and Whites: Data from the Alzheimer's Disease Center

  • Carey E. Gleason
    Correspondence
    Corresponding author. Tel.: +1-608-280-7000; Fax: +1-608-280-7291.
    Affiliations
    Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA

    Wisconsin Alzheimer's Disease Research Center, Madison, WI, USA

    Geriatric Research, Education and Clinical Center (11G), William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
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  • Derek Norton
    Affiliations
    Department of Biostatistics and Medical Informatics, University of Wisconsin, Madison, WI, USA
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  • Megan Zuelsdorff
    Affiliations
    Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA

    Wisconsin Alzheimer's Disease Research Center, Madison, WI, USA
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  • Susan F. Benton
    Affiliations
    Wisconsin Alzheimer's Disease Research Center, Madison, WI, USA

    Department of Family Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
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  • Mary F. Wyman
    Affiliations
    Wisconsin Alzheimer's Disease Research Center, Madison, WI, USA

    Geriatric Research, Education and Clinical Center (11G), William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
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  • Naomi Nystrom
    Affiliations
    Wisconsin Alzheimer's Disease Research Center, Madison, WI, USA

    Minnesota Department of Human Services, MN, USA
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  • Nickolas Lambrou
    Affiliations
    Wisconsin Alzheimer's Disease Research Center, Madison, WI, USA

    Geriatric Research, Education and Clinical Center (11G), William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
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  • Hector Salazar
    Affiliations
    Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA

    Wisconsin Alzheimer's Disease Research Center, Madison, WI, USA
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  • Rebecca L. Koscik
    Affiliations
    Department of Medicine, Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
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  • Erin Jonaitis
    Affiliations
    Department of Medicine, Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
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  • Fabu Carter
    Affiliations
    Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA

    Wisconsin Alzheimer's Disease Research Center, Madison, WI, USA
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  • Brieanna Harris
    Affiliations
    Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA

    Wisconsin Alzheimer's Disease Research Center, Madison, WI, USA
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  • Alexander Gee
    Affiliations
    Nehemiah Center for Urban Leadership Development, Madison, WI, USA
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  • Nathaniel Chin
    Affiliations
    Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA

    Wisconsin Alzheimer's Disease Research Center, Madison, WI, USA
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  • Frederick Ketchum
    Affiliations
    Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
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  • Sterling C. Johnson
    Affiliations
    Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA

    Wisconsin Alzheimer's Disease Research Center, Madison, WI, USA

    Geriatric Research, Education and Clinical Center (11G), William S. Middleton Memorial Veterans Hospital, Madison, WI, USA

    Department of Medicine, Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
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  • Dorothy F. Edwards
    Affiliations
    Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA

    Wisconsin Alzheimer's Disease Research Center, Madison, WI, USA

    Department of Kinesiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
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  • Cynthia M. Carlsson
    Affiliations
    Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA

    Wisconsin Alzheimer's Disease Research Center, Madison, WI, USA

    Geriatric Research, Education and Clinical Center (11G), William S. Middleton Memorial Veterans Hospital, Madison, WI, USA

    Department of Medicine, Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
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  • Walter Kukull
    Affiliations
    Department of Epidemiology, University of Washington School of Public Health, Seattle, WA, USA

    National Alzheimer's Coordinating Center, Seattle, WA, USA
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  • Sanjay Asthana
    Affiliations
    Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA

    Wisconsin Alzheimer's Disease Research Center, Madison, WI, USA

    Geriatric Research, Education and Clinical Center (11G), William S. Middleton Memorial Veterans Hospital, Madison, WI, USA

    Department of Medicine, Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
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Published:October 07, 2019DOI:https://doi.org/10.1016/j.jalz.2019.07.015

      Abstract

      Introduction

      We examined the influence of enrollment factors demonstrated to differ by race on incident mild cognitive impairment and dementia using Alzheimer's Disease Center data.

      Methods

      Differences in rates of incident impairment between non-Latino Whites and Blacks (n = 12,242) were examined with age-at-progression survival models. Models included race, sex, education, source of recruitment, health factors, and family history of dementia.

      Results

      No significant race differences in progression were observed in cognitively unimpaired participants. In those with mild cognitive impairment at baseline, Whites evidenced greater risk for progression than Blacks. Enrollment factors, for example, referral source, were significantly related to progression.

      Discussion

      The finding that Blacks demonstrated lower rate of progression than Whites is contrary to the extant literature. Nested-regression analyses suggested that selection-related factors, differing by race, may account for these findings and influence our ability to accurately estimate risk for progression. It is potentially problematic to make racial comparisons using Alzheimer's Disease Center data sets.

      Keywords

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