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Dementia, brain structure, and vascular risk factors in very old blacks and whites

Liu, Ge (2014) Dementia, brain structure, and vascular risk factors in very old blacks and whites. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Dementia is a disease of old age, and a major cause of disability and mortality in the elderly. African American or blacks have higher dementia prevalence and incidence than Caucasians or whites, and such racial disparities tend to be largest in the oldest old (≥ 85 years of age). Moreover, the oldest old is the fastest growing segment of the elderly population in US. Therefore, reducing racial disparities in dementia in the oldest old is of high public health relevance.
Racial differences in dementia should have neurological correlates on racial differences in brain structure. However, among previous studies examining racial differences in brain structure, most applied neuroimaging methods with low resolution, and detected only brain macro-structural characteristics in cohorts of young old adults. Moreover, the sample sizes of oldest old blacks in previous works were too small to draw final conclusions.
In this dissertation, a review of dementia, brain structure, and vascular risk factors is conducted first (Section 2), followed by an overview of their racial differences between elderly blacks and whites (Section 3). Gaps in knowledge and a proposal to address these gaps are presented in Section 4 and Section 5. The proposal involves leveraging an existing cohort of community-dwelling black and white adults (≥ 79 years of age) into an evaluation of brain structure and dementia. In this cohort, cutting-edge and high resolution neuroimaging modalities have been applied to obtain measures of brain structure at baseline and three years after, and data on vascular risk factors have been recorded at regular intervals in the previous decade.
This dissertation work will not only provide estimates of dementia prevalence rates in very old blacks and whites in the context of other important determinants of dementia, but also offer new evidence for the pathophysiology of the association between race and dementia. The primary hypothesis is that racial differences in dementia or cognition is related to racial differences in vascular risk factors, and this is explained by racial differences in brain structural abnormalities.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Liu, Gegel13@pitt.eduGEL13
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairRosano, CaterinaRosanoC@edc.pitt.eduCAR2350
Committee MemberLopez, Oscar L.lopezol@upmc.eduOLLOPEZ
Committee MemberSekikawa, Akiraakira@pitt.eduAKIRA
Committee MemberBoudreau, Robert MBoudreauR@edc.pitt.eduROB21
Committee MemberAizenstein, Howard Jaizensteinhj@upmc.eduAIZEN
Committee MemberSonger, Thomastjs@pitt.eduTJS
Date: 29 September 2014
Date Type: Publication
Defense Date: 26 June 2014
Approval Date: 29 September 2014
Submission Date: 21 July 2014
Access Restriction: 2 year -- Restrict access to University of Pittsburgh for a period of 2 years.
Number of Pages: 132
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Epidemiology
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: brain imaging;Diffusion Tensor Imaging;aging;dementia;racial disparities;cognitive function
Date Deposited: 29 Sep 2014 21:02
Last Modified: 19 Dec 2016 14:42


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