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. 2024;97(2):649-658.
doi: 10.3233/JAD-230729.

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

Lewis B Morgenstern  1   2 , Emily M Briceño  1   3 , Roshanak Mehdipanah  4 , Wen Chang  5 , Lisa Lewandowski-Romps  5 , Xavier F Gonzales  6 , Deborah A Levine  1   7 , Kenneth M Langa  5   7   8 , Nelda Garcia  1 , Noreen Khan  1 , Darin B Zahuranec  1 , Steven G Heeringa  5
Affiliations

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

Lewis B Morgenstern et al. J Alzheimers Dis. 2024.

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.

Trial registration: ClinicalTrials.gov NCT03403257.

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

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Conflict of interest statement

CONFLICT OF INTEREST

Kenneth M. Langa receives grant funding from the NIA and Alzheimer's Association and consults on NIH-funded projects related to identifying dementia in population-based studies. Lewis B. Morgenstern, Emily M. Briceño, Roshanak Mehdipanah, Deborah A. Levine, Darin B. Zahuranec, and Steven G. Heeringa receive grant funding from the NIH.

Figures

Figure 1:
Figure 1:. Course of the Study Samples
*ABS-address abased sample;HU-housing unit; HH-household ** The cognitive status for these 626 participants (352 FtF/NH and 274 Telephone) were by default assigned as 'Normal'. *** Manly-Jones Dementia Classification Algorithm was applied to 520 non-waived-assent participants (370 FtF/NH and 150 Telephone) to classify their cognitive status. 27 waived assent participants were by default assigned as 'Dementia'.
Figure 2:
Figure 2:. Flowchart of participants who completed the Harmonized Cognitive Assessment Protocol (HCAP)
+ The reported sample size at each node was based on the average of 30 replicates
See this image and copyright information in PMC

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