Racial and Ethnic Disparities in Dementia Risk Among Individuals With Low Education

Am J Geriatr Psychiatry. 2018 Sep;26(9):966-976. doi: 10.1016/j.jagp.2018.05.011. Epub 2018 May 23.

Abstract

Introduction: As higher dementia prevalence in ethnic minority groups could be attributed to low education, we studied individuals with low education and explored potential factors driving dementia disparities.

Methods: We examined differences in dementia risk between low-educated non-Hispanic whites, Hispanics, and African Americans, and the impact of lifetime risk factors using data from the nationally representative Aging, Demographics, and Memory Study (N = 819).

Results: As indicated by Cox regression modeling, dementia risk of low-educated individuals was not significantly different between ethnic groups but was related to having an APOE e4 allele (hazard ratio [HR] 1.89), depression (HR 1.67), stroke (HR 1.60), and smoking (HR 1.32). Further, even in people with low education, every additional year of education decreased dementia risk (HR 0.95).

Discussion: Our findings imply that higher dementia prevalence in ethnic minorities may be attributable to low education, especially among Hispanics, in addition to other risk factors.

Keywords: Racial and ethnic minorities; cognitive functioning; dementia risk; disparities; education; hispanic paradox; lifetime risk; longitudinal cohort study.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aging / ethnology*
  • Black or African American / ethnology*
  • Dementia / ethnology*
  • Educational Status*
  • Female
  • Health Status Disparities*
  • Health Surveys
  • Hispanic or Latino / statistics & numerical data*
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Prevalence
  • Risk Factors
  • United States / ethnology
  • White People / ethnology*