Race and cognitive decline among community-dwelling elders with mild cognitive impairment: findings from the Memory and Medical Care Study.

Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
Aging and Mental Health (Impact Factor: 1.78). 10/2011; 16(3):372-7. DOI: 10.1080/13607863.2011.609533
Source: PubMed

ABSTRACT Previous studies have reported conflicting findings on the relationship between race and cognitive decline in elders with dementia. Few studies have examined the role of race in cognitive decline in mild cognitive impairment (MCI). We investigate the relationship between race and cognitive decline in participants with MCI in a community-based, longitudinal study of cognitively impaired elders.
Based on a validated method utilizing a neuropsychiatric battery, 133 subjects [mean age: 78.7 years (SD = 6.5); female: 112 (76.7%); black: 59 (44.4%)] out of 512 participants in the Memory and Medical Care Study were diagnosed with MCI. The main outcome measure was the Telephone Interview for Cognitive Status (TICS) score over three years. Other baseline subject characteristics (demographics, health-related variables, behavioral, and psychiatric symptoms) were included in the analysis.
Overall, the three-year decline in mean TICS score was significantly higher among African Americans than non-African Americans [3.31 (SD: 7.5) versus 0.96 (SD: 3.0), t-value = 1.96, p-value = 0.05]. General estimating equation analyses revealed that African American race was associated with a faster rate of cognitive decline in all models.
The rate of cognitive decline in MCI appears to be faster in African Americans than non-African Americans in the community. Diagnosis of MCI among African American elders could lead to early interventions to prevent or delay cognitive decline in the future.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To examine the effect of demographic variables on scores on the modified Telephone Interview for Cognitive Status (mTICS) in a healthy cohort and develop demographically corrected normative data. Observational. Primarily academic medical centers. 576 healthy older adults. mTICS. Age and education significantly correlated with mTICS score, and sex differences were also observed on this score. Ethnicity differences were not observed. Using regression equations, age, education, and sex significantly predicted mTICS total score. By using these corrections, an individual's cognitive status may be more accurately predicted with this telephone screening instrument, although clinical validation is needed.
    The American journal of geriatric psychiatry: official journal of the American Association for Geriatric Psychiatry 10/2013; 22(12). DOI:10.1016/j.jagp.2013.08.007 · 3.52 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To examine whether observed differences in dementia rates between black and white older people living in the community could be explained by measures of socioeconomic status (income, financial adequacy, education, and literacy) and health related factors. Prospective cohort study. General community from two clinic sites in the United States (Pittsburgh, Pennsylvania and Memphis, Tennessee). 2457 older people (mean age 73.6 years; 1019 (41.5%) black; 1233 (50.2%) women), dementia-free at baseline, in the Health, Aging, and Body Composition study. Dementia was determined over 12 years (ending January 2011) by prescribed dementia drugs, hospital records, and decline in global cognitive scores. The influence of socioeconomic status and health related factors on dementia rates was examined in a series of Cox proportional hazard models in which these variables were added sequentially in covariate blocks. Over follow-up, 449 (18.3%) participants developed dementia. Black participants were more likely than white participants to develop dementia (211 (20.7%) v 238 (16.6%), P<0.001; unadjusted hazard ratio 1.44, 95% confidence interval 1.20 to 1.74). The hazard ratio lessened somewhat after adjustment for demographics, apolipoprotein E e4, comorbidities, and lifestyle factors (1.37, 1.12 to 1.67) but was greatly reduced and no longer statistically significant when socioeconomic status was added (1.09, 0.87 to 1.37). These findings suggest that differences in the burden of risk factors, especially socioeconomic status, may contribute to the higher rates of dementia seen among black compared with white older people. Strategies aimed at reducing these disparities may favorably affect the incidence of dementia.
    BMJ (online) 12/2013; 347:f7051. DOI:10.1136/bmj.f7051 · 16.38 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Despite the growing use of the modified Telephone Interview for Cognitive Status (mTICS) as a cognitive screening instrument, it does not yet have demographic corrections. Demographic data, mTICS, and a neuropsychological battery were collected from 274 community-dwelling older adults with intact cognition or mild cognitive impairments. Age, education, premorbid intellect, and depression were correlated with mTICS scores. Using regression equations, age and education significantly predicted mTICS total score, and depression and premorbid intellect further enhanced this prediction. These results were comparable when only examining the 153 cognitively intact subjects. By using these corrections, clinicians and researchers can more accurately predict an individual's cognitive status with this telephone screening measure.
    The Clinical Neuropsychologist 06/2013; 27(7). DOI:10.1080/13854046.2013.809794 · 1.58 Impact Factor

Full-text (2 Sources)

Available from
Jun 4, 2014