Liu, Ge
(2014)
Dementia, brain structure, and vascular risk factors in very old blacks and whites.
Doctoral Dissertation, University of Pittsburgh.
(Unpublished)
Abstract
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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Details
| Item Type: |
University of Pittsburgh ETD
|
| Status: |
Unpublished |
| Creators/Authors: |
|
| ETD Committee: |
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| 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 |
| URI: |
http://d-scholarship.pitt.edu/id/eprint/22652 |
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