Astrid Suchy-Dicey1,2, Dean Shibata3, Brenna Cholerton4, Lonnie Nelson5, Darren Calhoun6, Tauqeer Ali7, Thomas J Montine4, W T Longstreth8, Dedra Buchwald1,2, Steven P Verney9. 1. Initiative for Research and Education to Advance Community Health, Washington State University, Seattle, WA, USA. 2. Elson S Floyd College of Medicine, Washington State University, Seattle, WA, USA. 3. Department of Radiology, University of Washington, Seattle, WA, USA. 4. Department of Pathology, Stanford University, Palo Alto, CA, USA. 5. College of Nursing, Washington State University, Seattle, WA, USA. 6. Phoenix Field Office MedStar Research Institute, Phoenix, AZ, USA. 7. Center for American Indian Health Research, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA. 8. Departments of Neurology and Epidemiology, University of Washington, Seattle, WA, USA. 9. Department of Psychology and Psychology Clinical Neuroscience Center, University of New Mexico, Albuquerque, NM, USA.
Abstract
OBJECTIVE: American Indians experience substantial health disparities relative to the US population, including vascular brain aging. Poorer cognitive test performance has been associated with cranial magnetic resonance imaging findings in aging community populations, but no study has investigated these associations in elderly American Indians. METHODS: We examined 786 American Indians aged 64 years and older from the Cerebrovascular Disease and its Consequences in American Indians study (2010-2013). Cranial magnetic resonance images were scored for cortical and subcortical infarcts, hemorrhages, severity of white matter disease, sulcal widening, ventricle enlargement, and volumetric estimates for white matter hyperintensities (WMHs), hippocampus, and brain. Participants completed demographic, medical history, and neuropsychological assessments including testing for general cognitive functioning, verbal learning and memory, processing speed, phonemic fluency, and executive function. RESULTS: Processing speed was independently associated with the presence of any infarcts, white matter disease, and hippocampal and brain volumes, independent of socioeconomic, language, education, and clinical factors. Other significant associations included general cognitive functioning with hippocampal volume. Nonsignificant, marginal associations included general cognition with WMH and brain volume; verbal memory with hippocampal volume; verbal fluency and executive function with brain volume; and processing speed with ventricle enlargement. CONCLUSIONS: Brain-cognition associations found in this study of elderly American Indians are similar to those found in other racial/ethnic populations, with processing speed comprising an especially strong correlate of cerebrovascular disease. These findings may assist future efforts to define opportunities for disease prevention, to conduct research on diagnostic and normative standards, and to guide clinical evaluation of this underserved and overburdened population.
OBJECTIVE: American Indians experience substantial health disparities relative to the US population, including vascular brain aging. Poorer cognitive test performance has been associated with cranial magnetic resonance imaging findings in aging community populations, but no study has investigated these associations in elderly American Indians. METHODS: We examined 786 American Indians aged 64 years and older from the Cerebrovascular Disease and its Consequences in American Indians study (2010-2013). Cranial magnetic resonance images were scored for cortical and subcortical infarcts, hemorrhages, severity of white matter disease, sulcal widening, ventricle enlargement, and volumetric estimates for white matter hyperintensities (WMHs), hippocampus, and brain. Participants completed demographic, medical history, and neuropsychological assessments including testing for general cognitive functioning, verbal learning and memory, processing speed, phonemic fluency, and executive function. RESULTS: Processing speed was independently associated with the presence of any infarcts, white matter disease, and hippocampal and brain volumes, independent of socioeconomic, language, education, and clinical factors. Other significant associations included general cognitive functioning with hippocampal volume. Nonsignificant, marginal associations included general cognition with WMH and brain volume; verbal memory with hippocampal volume; verbal fluency and executive function with brain volume; and processing speed with ventricle enlargement. CONCLUSIONS: Brain-cognition associations found in this study of elderly American Indians are similar to those found in other racial/ethnic populations, with processing speed comprising an especially strong correlate of cerebrovascular disease. These findings may assist future efforts to define opportunities for disease prevention, to conduct research on diagnostic and normative standards, and to guide clinical evaluation of this underserved and overburdened population.
Entities:
Keywords:
Cerebrovascular disorders; Cognitive aging; Cultural diversity; Health status disparities; Indians; Magnetic resonance imaging; Neuropsychological tests; North American; Vascular brain injury
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