2012-2013 Alzheimer’s and Related Diseases Research Award*Vascular risk factors and cognition in African Americans
*The Virginia Center on Aging which administers the Alzheimer’s and Related Diseases Research Award Fund for the Commonwealth of Virginia, provides seed money to researchers in Virginia to stimulate innovative research into biomedical and psychosocial aspects of dementia, including cell biology, caregiving, and animal modeling.
Vascular risk factors and cognition in African Americans
Carol Manning, PhD, ABPP-CN, Steven DeKosky, MD, and Ishan C. Williams, PhD
University of Virginia
Vascular risk factors are associated with vascular dementia and more recently have been associated with increased risk for Alzheimer’s disease (AD). African-Americans have high rates of vascular risk factors and recently have been found to have higher overall rates of dementia than Caucasians. However, dementia and Mild Cognitive Impairment, often a precursor to frank dementia, may be underrecognized in African-Americans coming in for general medical appointments. In this study, two groups of African-Americans who are coming to see their primary care physicians will be given cognitive testing: 1) people without vascular risk factors and 2) people with high blood pressure, diabetes, high cholesterol, history of stroke, or those who smoke cigarettes. Participants will not be coming to see their providers because of cognitive complaints. It is hypothesized that cognitive impairments will be greater in the participants with vascular risk factors and that in both groups cognitive deficits are underrecognized secondary to a number of factors including limited appointment time, and lack of knowledge about expected cognitive change and risks for cognitive change.
(The investigators may be contacted: Dr. Manning 434/982-1012; firstname.lastname@example.org; Dr. DeKosky 434/924-5118; email@example.com; Dr. Williams 434/924-0480;firstname.lastname@example.org)
Vascular risk factors are associated with dementia. African-Americans have high rates of vascular risk factors and have high rates of dementia. However, dementia and Mild Cognitive Impairment (MCI), often a sign of early dementia, may be under-recognized in African-Americans coming in for general medical appointments. In this study, ninety-six African-Americans who were coming in to see their primary care physicians had cognitive testing immediately. None of the participants were coming to see their doctors because of cognitive complaints. Vascular risks were identified through the participants’ medical records. Vascular risk factors included high blood pressure, diabetes, high cholesterol, history of stroke and cigarette smoking. Cognition was examined in relation to vascular risk factors. Concern about cognitive functioning in participants and physicians was also examined. Data revealed that vascular risks had a negative impact on cognition. According to our cognitive test results, 41% percent of our sample had MCI, despite a lack of cognitive complaints. In addition, neither the patients nor the physicians were aware of the degree of cognitive impairment. African-Americans, coming to see their primary care physicians for reasons other than memory, had high rates of cognitive impairment and vascular risk factors. Vascular risks were correlated with cognitive impairment. These findings indicate high rates of unrecognized cognitive impairment in this population and suggest that patients and physicians may be unaware of these difficulties. Lack of awareness may be secondary to limited appointment time and poor knowledge of risks for cognitive change.
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