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Discrepancy in prevalence of Alzheimer’s disease and Related Dementias among African American and Hispanic women: a qualitative literature review

Royse, Sarah Kolibash (2021) Discrepancy in prevalence of Alzheimer’s disease and Related Dementias among African American and Hispanic women: a qualitative literature review. Master Essay, University of Pittsburgh.

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Abstract

Introduction: The population of older adults with Alzheimer’s disease and Related Dementias (ADRD) is growing larger and more diverse. Prevalence of ADRD is higher in African American (AA) and Hispanic populations relative to non-Hispanic whites (nHW), with larger differences for women compared to men of the same race. Given the public health importance of this issue, we sought to determine if AA and Hispanic women exhibit worse ADRD pathology compared to men of the same race and nHW women. We hypothesized that such differences may explain the discrepancy in ADRD prevalence.

Methods: We evaluated 932 articles that measured at least one of the following biomarkers of ADRD pathology in vivo and/or postmortem: beta-amyloid (Aß), tau, neurodegeneration, and cerebral small vessel disease (cSVD). Criteria for inclusion were: 1) mean age of participants > 65 years; 2) inclusion of nHW participants and either AA or Hispanics or both; 3) direct comparison of ADRD pathology between racial groups.

Results: We included 26 articles (Aß=9, tau=6, neurodegeneration=16, cSVD=18), with seven including sex-by-race comparisons. Studies differed by sampling source (e.g. clinic or population), multivariable analytical approach (e.g. adjusted for risk factors for AD), and cognitive status of participants. Aß burden did not differ by race or sex. Tau differed by race (AA<nHW), and by sex (women>men). Both severity of neurodegeneration and cSVD differed by race (AA>nHW; Hispanics <nHW) and sex (women<men). Among the studies that tested sex-by-race interactions, results were not significant.

Conclusions: Few studies have examined the burden of ADRD pathology by both race and sex. The higher prevalence of ADRD in women compared to men of the same race may be due to both higher tau load and more vulnerability to cognitive decline in the presence of similar Aß and cSVD burden. AA women may also exhibit more neurodegeneration and cSVD relative to nHW populations. Studies suggest that between-group differences in ADRD pathology are complex, but they are too sparse to completely explain why minority women have the highest ADRD prevalence. Future work should recruit diverse cohorts, compare ADRD biomarkers by both race and sex, and collect relevant risk factor and cognitive data.


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Details

Item Type: Other Thesis, Dissertation, or Long Paper (Master Essay)
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Royse, Sarah Kolibashsak225@pitt.edusak2250000-0003-4846-0180
Contributors:
ContributionContributors NameEmailPitt UsernameORCID
Committee ChairRosano, Caterinarosanoc@edc.pitt.edurosanocUNSPECIFIED
Committee MemberCohen, Annsnitzbe@upmc.eduUNSPECIFIEDUNSPECIFIED
Committee MemberSnitz, Bethcohenad@upmc.eduUNSPECIFIEDUNSPECIFIED
Date: 10 May 2021
Date Type: Completion
Submission Date: 5 April 2021
Access Restriction: 2 year -- Restrict access to University of Pittsburgh for a period of 2 years.
Number of Pages: 66
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Epidemiology
Degree: MPH - Master of Public Health
Thesis Type: Master Essay
Refereed: Yes
Uncontrolled Keywords: Alzheimer's disease, African American, Hispanic, sex differences, tau, neurodegeneration, cerebral small vessel disease, Amyloid
Date Deposited: 10 May 2021 22:39
Last Modified: 10 May 2023 05:15
URI: http://d-scholarship.pitt.edu/id/eprint/40765

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