Assessing cognitive impairment in an ethnically diverse cohort of oldest-old: the life after 90 study

Assessing cognitive impairment in an ethnically diverse cohort of oldest-old: the life after 90 study

Background Though dementia rates vary by racial or ethnic groups, it is unknown if these disparities remain among those aged 90 or older. Aims To test this hypothesis, we used baseline clinical evaluation of 541 ethnically and racially diverse individuals participating in the LifeAfter90 Study to as...

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Published in:Aging clinical and experimental research Vol. 35; no. 5; pp. 979 - 986
Main Authors: Petrosyan, Diana, Corrada, Maria M., Kawas, Claudia H., Demoz, Asmeret, Ganzon, Czarina, Popovich, Oksana, Gaied, Reham, Mungas, Dan, Gilsanz, Paola, Vieira, Katharine E., Whitmer, Rachel A., DeCarli, Charles
Format: Journal Article
Language:English
Published: Cham Springer International Publishing 01-05-2023
Springer Nature B.V
Subjects:
Aged, 80 and over
Cognition
Cognition & reasoning
Cognition Disorders - psychology
Cognitive ability
Cognitive Dysfunction - diagnosis
Cognitive Dysfunction - epidemiology
Dementia
Dementia - diagnosis
Dementia - psychology
Ethnicity
Female
Geriatrics/Gerontology
Humans
Male
Medicine
Medicine & Public Health
Minority & ethnic groups
Neuropsychological Tests
Original
Original Article
Race
Oldest-old
3MS
Cognitive testing
Diverse population
Epidemiology
Cognitive impairment
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Summary:Background Though dementia rates vary by racial or ethnic groups, it is unknown if these disparities remain among those aged 90 or older. Aims To test this hypothesis, we used baseline clinical evaluation of 541 ethnically and racially diverse individuals participating in the LifeAfter90 Study to assess how associations between core demographic characteristics and measures of physical and cognitive performance differ across the racial/ethnic groups. Methods Participants in this study were long-term non-demented members of Kaiser Permanente Northern California. They were clinically evaluated and diagnosed with normal or impaired cognition (mild cognitive impairment and dementia) through an in-person comprehensive clinical assessment consisting of a detailed medical history, physical and neurological examination, functional, and cognitive tests. Results The average age at enrollment was 93.0 ± 2.6 years, 62.4% female and 34.2% non-Hispanic White. At initial evaluation 301 participants had normal cognition and 165 had mild cognitive impairment (MCI) and despite screening, 69 participants were determined to have dementia. Age, education, 3MS, FAQ and CDR scores were significantly associated with cognitive impairment (normal versus MCI and dementia), but not gender. There was a significant univariate association between race/ethnicity and cognitive impairment ( p  < 0.02) being highest among Black (57.4%) and lowest among Asian (32.7%) individuals. After adjustment for age, gender, and education, however, prevalence of cognitive impairment was not influenced by race or ethnicity. Conclusion Our results confirm the ability to reliably assess clinical diagnosis in a diverse sample of very old individuals.
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ISSN:1720-8319
1594-0667
1720-8319
DOI:10.1007/s40520-023-02368-0