Chronic Health Illnesses as Predictors of Mild Cognitive Impairment Among African American Older Adults

Abstract

Approximately 5.5 million individuals are diagnosed with Alzheimer's disease (AD) dementia, a number which includes those with mild cognitive impairment and asymptomatic individuals with biomarkers of AD. There is a higher incidence of mild cognitive impairment (MCI) in African American populations as compared to White populations, even when controlling for sociodemographic factors. The existing body of ethnically/racially targeted research on MCI has been limited by few studies with the ability to generalize to African American communities. This study sought to examine whether medical conditions which occur at a higher rate in African American individuals increase the hazard of subsequent MCI development. A secondary data analysis of the National Alzheimer's Coordinating Center Uniform Data Set was employed to examine the associations between health conditions (congestive heart failure, traumatic brain injury, diabetes, hypertension, hypercholesterolemia, B12 deficiency, thyroid disease) and their relationship to MCI. The analytic sample included 2847 participants with 9872 observations. Binary logistic generalized estimating equation modeling was used to examine repeated measures over the course of 1-11 observations. Education was associated with MCI development, specifically those with some college or college graduates (p < 0.001) and more than college (p = 0.002). Female sex was associated with development of MCI (p < 0.001). African Americans with traumatic brain injury (TBI) were more likely to develop MCI (p < 0.001) compared to those with no reports of a TBI. Inactive thyroid conditions decreased the risk of MCI development (p = 0.005) compared to those without thyroid disease. Though vascular factors are often attributed to higher mortality and neurodegeneration in African Americans, congestive heart failure, diabetes, high cholesterol, hypertension, diabetes, nor seizures were associated with an increased risk of MCI development. Findings from this study provide formative data to develop targeted interventions for subsets of the African American community, including those with higher educational levels, those with TBI, and those with a history of thyroid disease. While it may not be possible to prevent MCI development, it is possible to modify lifestyle behaviors contributing to these health conditions, such as falls that are often experienced by older adults. Practitioners can increase awareness, knowledge, and resources relevant to clients.