Chengjie Xiong1,2, Jingqin Luo1,3,4, Dean Coble1,2, Folasade Agboola1,2, Walter Kukull5,6, John C Morris2,7,8. 1. Division of Biostatistics, Washington University School of Medicine, St. Louis, Missouri, USA. 2. Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, Missouri, USA. 3. Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA. 4. Siteman Cancer Center Biostatistics Core, Washington University School of Medicine, St. Louis, Missouri, USA. 5. Department of Epidemiology, University of Washington, Seattle, Washington, USA. 6. National Alzheimer's Coordinating Center, University of Washington, Seattle, Washington, USA. 7. Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA. 8. Departments of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri, USA.
Abstract
INTRODUCTION: We aim to determine racial disparities and their modifying factors in risk for Alzheimer's disease (AD) dementia among cognitively normal individuals 65 years or older. METHODS: Longitudinal data from the National Alzheimer's Coordinating Center Uniform Data Set on 1229 African Americans (AAs) and 6679 whites were analyzed for the risk of AD using competing risk models with death as a competing event. RESULTS: Major AD risk factors modified racial differences which, when statistically significant, occurred only with older age among APOE ε4 negative individuals, but also with younger age among APOE ε4 positive individuals. The racial differences favored AAs among individuals with body mass index (BMI) < 30, but whites among individuals with a high BMI (≥ 30), and were additionally modified by sex, education, hypertension, and smoking status. CONCLUSIONS: The presence, direction, and relative magnitude of racial disparity for AD represent an interactive function of major AD and cerebrovascular risk factors.
INTRODUCTION: We aim to determine racial disparities and their modifying factors in risk for Alzheimer's disease (AD) dementia among cognitively normal individuals 65 years or older. METHODS: Longitudinal data from the National Alzheimer's Coordinating Center Uniform Data Set on 1229 African Americans (AAs) and 6679 whites were analyzed for the risk of AD using competing risk models with death as a competing event. RESULTS: Major AD risk factors modified racial differences which, when statistically significant, occurred only with older age among APOE ε4 negative individuals, but also with younger age among APOE ε4 positive individuals. The racial differences favored AAs among individuals with body mass index (BMI) < 30, but whites among individuals with a high BMI (≥ 30), and were additionally modified by sex, education, hypertension, and smoking status. CONCLUSIONS: The presence, direction, and relative magnitude of racial disparity for AD represent an interactive function of major AD and cerebrovascular risk factors.
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