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Lookup NU author(s): Professor Matthew Prina
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© The Author(s) 2024. Published by Oxford University Press on behalf of The Gerontological Society of America.Background and Objectives: The racial or ethnic disparity in the burden of dementia exists among older adults in the United States, whereas gaps remain in understanding the synergic effect of multiple social determinants of health on diminishing this disparity. We aim to build a polysocial score for dementia and investigate the racial or ethnic difference in dementia risk among older persons with different polysocial score categories. Research Design and Methods: In this prospective cohort study, we utilized longitudinal data from the Health and Retirement Study in the United States recruiting 6 945 participants aged ≥65 years who had data on 24 social determinants of health in 2006/2008. The dementia status of participants was measured by a modified version of the Telephone Interview of Cognitive Status. The stepwise Cox regression was applied to select social determinants of health associated with incident dementia to construct a polysocial score. The multivariable Poisson model and linear mixed model were utilized to investigate the associations between polysocial score and incident dementia and cognitive decline, respectively. Results: Eight social determinants of health were used to build the polysocial score. Non-Hispanic Black older participants had a higher incidence rate (incidence rate difference [IRD] = 22.7; 95% confident interval [95% CI] = 12.7–32.8) than non-Hispanic White older adults in the low polysocial score, while this difference was substantially attenuated in the high polysocial score category (IRD = 0.5; 95% CI = −6.4 to −7.5). The cognitive decline of non-Hispanic older Black adults with high polysocial score was 84.6% slower (averaged cognitive decline: non-Hispanic White: −2.4 [95% CI = −2.5 to −2.3] vs non-Hispanic Black: −1.3 [95% CI = −1.9 to −0.8]) than that of non-Hispanic older White persons. Discussion and Implications: These findings may help comprehensively understand and address racial and ethnic disparities in dementia risk and may be integrated into existing dementia prevention programs to provide targeted interventions for community-dwelling older adults with differentiated social disadvantages.
Author(s): Ping Y, Odden MC, Chen X, Prina M, Xu H, Xiang H, Wu C
Publication type: Article
Publication status: Published
Journal: Innovation in Aging
Year: 2024
Volume: 8
Issue: 10
Online publication date: 28/08/2024
Acceptance date: 15/08/2024
Date deposited: 04/11/2024
ISSN (electronic): 2399-5300
Publisher: Oxford University Press
URL: https://doi.org/10.1093/geroni/igae078
DOI: 10.1093/geroni/igae078
Data Access Statement: This article did not contain any individual data in any form. Availability of data and materials: Data from the 2006 to 2016 waves of the Health and Retirement Study were open-accessed from the following link: https://hrs.isr.umich.edu/documentation/data-descriptions.
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