Aging / Alzheimer's
Permanent URI for this collectionhttps://hdl.handle.net/20.500.12503/32538
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Browsing Aging / Alzheimer's by Author "Johnson, Leigh"
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Item Exploring the Association between Reproductive Health and Cognitive Function in Hispanic and Non-Hispanic Women: Insights from a HABS-HD Study(2024-03-21) Pham, Theresa; Johnson, LeighPurpose: Alzheimer’s disease (AD), a progressive neurodegenerative disease with nearly two-thirds of dementia cases found in women, leads to memory loss, cognitive deficits, and behavioral changes, significantly impacting daily life. Given the disproportionate effect of AD on women, it is crucial to understand the risk factors, including reproductive health variables, that may contribute to the development of dementia and AD. Such understanding can provide valuable insights for dementia prevention and the development of personalized, gender-specific medicine. This study aimed to examine the association between reproductive health variables such as bilateral oophorectomy and pregnancy complications and cognitive performance in Hispanic and non-Hispanic women. Method: Self-reported data from 309 cognitively normal women (165 non-Hispanic white and 144 Hispanic) enrolled in the Health and Aging Brain Study: Health Disparities (HABS-HD) project, an epidemiological study of aging in community-based participants, were analyzed. Reproductive health variables examined included bilateral oophorectomy, pregnancy complications, number of pregnancies, and number of children. The cognitive assessment comprised neuropsychological test scores in five domains: memory (logical memory I & II), executive functioning (digit symbol substitution), attention (digit span), language (F-A-S), and global cognition (mini‐mental state examination). Linear regression statistical analyses were conducted, with ethnicity serving as a stratification variable. Results: Linear regression analyses revealed significant associations between reproductive health variables and cognitive domains, with distinct patterns observed among ethnic groups. Bilateral oophorectomy was linked to decreased immediate memory in Hispanic women (B=.176, SE=1.691, t=2.211, p=.029) and lower language performance in non-Hispanic white women (B=-.228, SE=1.980, t=-2.682, p=.008). Pregnancy complications were associated with poorer attention scores in Hispanic women (B=.163; SE=.000, T=2.203, p=.029). However, the number of children and pregnancies were not associated with cognitive performance. Conclusion: This study suggests that reproductive health variables, such as bilateral oophorectomy and pregnancy complications, were differentially associated with cognitive assessment performance among Hispanic and non-Hispanic women. A surgical history of bilateral oophorectomy may be associated with a decline in cognitive performance in both Hispanic and non-Hispanic women. Limitations, including sample size constraints and reliance on self-reported medical history, are acknowledged. Nonetheless, this study underscores the need for continued investigation into the intersection of reproductive health and cognitive function to inform targeted interventions and personalized healthcare approaches for dementia prevention across diverse communities.Item Vascular and metabolic profiles related to white matter hyperintensities in a multiethnic cohort from the HABS-HD study(2024-03-21) Taylor, Douglas; Vintimilla, Raul; Hall, James; Johnson, Leigh; O'Bryant, SidPurpose: There are more than 6 million people living with Alzheimer’s disease (AD) in the United States. Mexican-Americans (MA) and African-Americans (AA) are disproportionally affected by AD and related dementias, and it is expected that these disparities will increase in the coming years. AD commonly presents with vascular dementia and research has shown the relationship between the two to be complex, with many individuals presenting with mixed dementia. Vascular dementia is commonly related to small vessel disease. Small vessel disease occurs when endothelial damage in cerebrovascular circulation causes ischemia, leading to microinfarcts. The microinfarcts show up as white matter hyperintensities (WMH) in MRI. Most research using WMH to study dementia has been completed with non-Hispanic whites (NHW), though studies have shown a higher incidence of metabolic factors related to AD in MA. It is our goal to use WMH to find further differences in vascular and metabolic factors related to AD among a cohort of NHW, MA, and AA. Method: A cross-sectional analysis of 2363 subjects from the HABS-HD cohort was conducted (967 NHW, 410 AA, and 986 MA). Participants underwent a clinical evaluation and a 3T brain MRI (Siemens Skyra). WMH volume was measured from FLAIR using the Statistical Parametric Mapping (SPM) Lesion Segmentation Tool. WMH were Log transform to achieve normality, and were adjusted for intracranial volume derived from Free3Surfer V6.0 analysis of T1MPRAGE. Fasting blood samples were collected, and clinical measures were conducted using standard procedures. Clinical, vascular, and metabolic risk factors (table 1) were used in linear regression models as predictors of WMH volume adjusted by intracranial volume (ICV). Age, sex, and education were entered as covariates. Results: The total sample was 62.3 percent female with a mean age of 65.4 years and 13.07 years of education. NHW were older, had more years of education, had lower BMI, lower systolic and diastolic blood pressure, and levels of triglycerides, HA1c, and EGFR when compared to AA and MA (p ≤0.005). In NHW, age, sex, education, SBP, DBP, and hypertension significantly predicted WMH volumes (p ≤ 0.005). Age, years of education and BMI were the only significant predictors of WMH volume in AA (p ≤ 0.005), while age, total cholesterol and T4 levels were significant predictors of WMH volume in MA (p ≤ 0.005). Having a diagnosis of diabetes or dyslipidemia, also predicted WMH volume in MA. Conclusion: Results showed that different factors contribute to WMH volume among different ethnicities. Results suggest that in NHW, a vascular profile is most relevant, while in MA and AA, a metabolic profile seems to be driven the association with WMH. Prospective studies are needed to further understand the how the different profiles among different ethnicities affect the presentation of WMH and pathology of SVD.