Browsing by Author "Vintimilla, Raul"
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Item Area deprivation index and cognitive function: A cross-sectional study of the HABS-HD cohort(2023) Benton, Abigail; Vintimilla, Raul; Hall, James; Johnson, Leigh; O'Bryant, SidPurpose: Dementia is an ever-growing group of disorders worldwide. It is proposed that neighborhood socioeconomic status (NSES) is linked with overall health, and this study will evaluate whether NSES is cross-sectionally associated with cognition in non-Hispanic White, African American, and Mexican American participants of the Health and Aging Brain: Health Disparities Study (HABS-HD). Methods: The HABS-HD is a longitudinal study conducted by the Institute for Translational Research at the University of North Texas Health Science Center. Participants (n=1634) were age 50 years or older, and underwent a clinical interview, neuropsychological exam battery, functional examination, head MRI, amyloid PET scan, and blood draw for clinical and biomarker analysis. NSES was measured using the national area deprivation index (ADI) percentile ranking, which considered the variables of education, employment, income, occupation, and housing. Cognition was assessed by the Mini-Mental State Examination, Trails B Exam, FAS Test, Spanish English Verbal Learning Test, and Digit-Symbol Substitution Test. The cognitive performance in those living in the 20% most disadvantaged neighborhoods was compared to those in the 80% least disadvantaged neighborhoods using multiple linear regression models with age, sex, education, and ethnicity as control variables. Results: Those in the most deprived neighborhood group were statistically significantly (p<0.05) younger, less educated, more likely to be female, and more likely to be Mexican American. The means of MMSE and Trails B test were lower in those living in the more deprived neighborhood group (p<0.05). When looking at the linear model of ADI and cognition, after adjusting for covariates, only Trails B scores were related to the higher deprived neighborhood group (t = -0.62, p <0.0001). Conclusion: Our study revealed that some measures of cognitive impairment were higher in people living in the top 20% disadvantaged neighborhoods. In future studies, specific markers of deprivation should be analyzed along with cognitive impairment to more specifically advocate for beneficial change. Further, due to sex and ethnicity being significant cofounders, analysis should be run by ethnicity to investigate this distinction.Item Association between inflammation, white matter hyperintensities, and executive function: the role of ethnicity.(2022) Brown, Frank; Vintimilla, Raul; Hall, James; Johnson, Leigh; O'Bryant, SidAssociation between inflammation, white matter hyperintensities, and executive function: the role of ethnicity. Frank Brown1, Raul Vintimilla2, James Hall2, Leigh Johnson2, Sid O'Bryant2, for the HABS-HD Study Team. 1University of North Texas 2University of North Texas Health Science Center, Institute for Translational Research Background: Systemic inflammation and cardiovascular risk factors (CVRF) impact neurological health and executive function. Neutrophils produce inflammatory mediators and lymphocytes regulate the inflammatory response. Neutrophil to lymphocyte ratio (NLR) has been used as a marker of systemic inflammation, and as a predictor of cardiovascular health. CVRF are correlated with white matter hyperintensity volume (WMH), an MRI indicator of cerebrovascular health. This study seeks to compare if there is a difference in the association between inflammation (NLR), WMH, and executive function among Mexican Americans and non-Hispanic Whites. Method: We analyzed data from 1083 (505 Mexican Americans and 578 non -Hispanic Whites) cognitively normal participants from the Health and Aging Brain Study (HABS-HD). All participants signed a written consent, and underwent a 3T MRI (Siemens Skyra), clinical labs, clinical evaluation, and cognitive testing. Differential blood cell counts were used to obtain NLR. WMH volume was measured from FLAIR using the Statistical Parametric Mapping (SPM) Lesion Segmentation Tool. Linear regression was used to predict the effect of NLR and Log transformed WMH adjusted for intracranial volume (derived from Freesurferv6.0 analysis of T1 MPRAGE) on Trails B z-score (executive function), and to evaluate if NLR can predict WMH volume. Analysis was split by ethnicity. Age, sex, and education were entered as covariates in the models. Results: Sixty-four percent of the total sample were female. Means for the whole sample were: age 66.02, education years 12.98, Trails B 0.19, WMH volume -0.035, and NLR 2.16. When compared to non-Hispanic Whites, Mexican Americans were significantly younger, less educated, had lower Trails B score, NLR values and WMH volume. NLR predicted Trails B scores (B = -0.14, t =-0.12, p = 0.004) only in Mexican American, while WMH predicted Trails B scores in Mexican American (B = -0.16, t = -3.02, p = 0.003), and Non-Hispanic Whites (B = -0.14, t = -4.33, p < 0.0001). Results remained significant after adjusting for age, sex, education. NLR predicted WMH volume (B = 0.13, t = 3.38, p = 0.001) only in Mexican American. Conclusion: Our findings suggest an association between NLR, WMH and executive function in Mexican Americans. NLR and WMH volume predicted Trails B scores in Mexican Americans. WMH predicted Trails B scores, but there was no association between NLR and executive function in non-Hispanic Whites. These findings demonstrate the importance of race consideration when assessing the relationship between inflammation, CVRF, WMH, and executive function.Item Association of Area Deprivation Index and hypertension, diabetes, dyslipidemia, and Obesity: A Cross-Sectional Study of the HABS-HD Cohort(Sage Publications, 2023-06-26) Vintimilla, Raul; Seyedahmadi, Armin; Hall, James R.; Johnson, Leigh A.; O'Bryant, Sid E.; Team, HABS-HD StudyObjective: This study aims to investigate the association between neighborhood deprivation and the prevalence of major cardiovascular disease (CVD) risk factors (hypertension, diabetes, dyslipidemia, and obesity) in a Mexican American (MA) population compared to NonHispanic Whites (NHW). Method: A cross-sectional analysis was conducted to include 1,867 subjects (971 MA and 896 NHW). Participants underwent a clinical interview, neuropsychological exam battery, functional examination, MRI of the head, amyloid PET scan, and blood draw for clinical and biomarker analysis. We use the Area Deprivation Index (ADI) Model to assign an ADI score to participants based on their neighborhoods. Descriptive, Cochran-Armitage test for trend, and odds ratio statistical analysis were applied. Results: Our results suggest that NHW had higher odds of having HTN, DM, and obesity in the most deprived neighborhoods, while MA showed no increased odds. The study also found that neighborhood deprivation contributed to diabetes in both MA and NHW and was associated with obesity in NHW. Conclusions: These findings highlighted the importance of addressing both individual and societal factors in efforts to reduce cardiovascular risk. Future research should explore the relationship between socio-economic status and cardiovascular risk in more detail to inform the development of targeted interventions.Item Association of Area Deprivation Index and hypertension, diabetes, dyslipidemia, and obesity: a cross-sectional study of the HABS-HD cohort.(2023) Seyedahmadi, Armin; Vintimilla, Raul; Hall, James; Johnson, Leigh; O'Bryant, SidBackground: Heart disease is a leading cause of death globally and the prevalence of cardiovascular disease (CVD) is expected to increase significantly in the United States over the next decade. Previous research has shown that socioeconomic status has a significant impact on CVD prevalence and outcomes, with risk factors for CVD being more prevalent in individuals from low socioeconomic groups. We aimed to investigate the association between neighborhood deprivation and the prevalence of major CVD risk factors (hypertension, diabetes, dyslipidemia, and obesity) in a Mexican American population compared to Non-Hispanic Whites. Methods: A cross-sectional analysis was conducted to include 1867 subjects. 971 self-identified as Mexican American (MA), and 896 as Non-Hispanic White (NHW). These participants underwent a clinical interview, neuropsychological exam battery, functional examination, MRI of the head, amyloid PET scan, and blood draw for clinical and biomarker analysis. They were also assigned an ADI score based on participants living in the best and worst neighborhoods according to Area Depravation Index (ADI) model. Results: Sixty percent of the sample was female. MA were significantly younger (mean age 63.37 vs 68.64) and less educated (mean education years 9.69 vs 15.61 than NHW. Additionally, MA had a significantly higher prevalence of HTN, DM, and obesity. Only 12.3% of Non-Hispanic Whites lived in the most deprived neighborhoods (percentile 4), while 57.5% of Mexican Americans lived in the percentile 4 ranking areas (p≤ .05). There was a significant difference between non-Hispanic White participants living in the least deprived neighborhoods compared to participants living in the most deprived neighborhoods for HTN (OR = 2.14, 95% CI [1.31, 3.48]), DM (OR = 3.42; 95% CI [1.67, 7.01]), and obesity (OR = 3.03, 95% CI [1.86 to 4.95]). There was no significant difference in the odds of having dyslipidemia between non-Hispanic Whites living in the ADI quartile 1 when compared to those living in the ADI quartile 4. These results remained significant after adjusting for age, sex, education, and cardiovascular risk factors. Conclusion: In conclusion, this study found the area deprivation index (ADI) is associated with cardiovascular risk factors such as hypertension, diabetes, dyslipidemia, and obesity. These findings suggest that socioeconomic status may play a role in the prevalence of certain health conditions among different ethnic groups. Further research is needed to understand the underlying mechanisms and to develop interventions that address health disparities among different ethnic populations.Item Cardiovascular Risk Factors, Cognitive Dysfunction, and Mild Cognitive Impairment(S. Karger AG, 2020-11-16) Vintimilla, Raul; Balasubramanian, Kishore; Hall, James R.; Johnson, Leigh A.; O'Bryant, Sid E.Objectives: The present study sought to evaluate the contribution of cardiovascular risk factors to cognitive functioning in a sample of Mexican Americans diagnosed with mild cognitive impairment (MCI). Methods: Hypertension, diabetes, dyslipidemia, and obesity were diagnosed based on self-report and/or standardized procedures. Cognitive function was measured with MMSE, Logical Memory I and II, Trail A & B, FAS, animal naming, and digit span tests. Independent samples t tests and two-way ANOVAs were conducted for analyses, adjusting for relevant covariates. We studied 100 Mexican Americans (65 female) with MCI, ages 50-86, from a longitudinal study of cognitive aging conducted at the University of North Texas Health Science Center. Results: A difference between subjects with and without obesity and memory scores was shown by t tests. Two-way ANOVAs detected an association between the coexistence of hypertension and diabetes with language measures, diabetes and dyslipidemia with executive function, and diabetes and obesity with memory and language measures. Conclusions: This study provides additional evidence about the link between cardiovascular risk factors and cognitive dysfunction in MCI subjects, and also demonstrated that comorbid risk factors increased the degree of cognitive deficit in many areas, which may indicate a higher risk of developing dementia.Item Carotid arterial stiffness and cerebral blood flow variability in individuals with mild cognitive impairment(2023) Bhuiyan, Nasrul; Davis, K. Austin; Vintimilla, Raul; Borzage, Matthew; Pahlevan, Niema; King, Kevin; Johnson, Leigh; O'Bryant, Sid; Rickards, CarolinePurpose: It is unclear whether cerebral blood flow variability is a sign of impaired vascular function or an adaptation to chronic cerebral hypoperfusion in individuals with cognitive dysfunction. Elevated arterial stiffness increases transmission of pulsatile pressure to the brain, but the relationship between arterial stiffness, the magnitude of cerebral blood flow variability, and cognitive dysfunction is unknown. In this pilot study, we hypothesized that carotid artery stiffness would be higher in individuals with mild cognitive impairment (MCI) compared with individuals with normal cognition (NC), resulting in higher cerebral blood flow variability. Methods: In individuals with MCI (N=5) or NC (N=7), R-wave to common carotid artery (CCA) pulse wave velocity (PWV) was assessed as an index of arterial stiffness (via tonometry). CCA velocity (CCAv) and middle cerebral artery velocity (MCAv) were measured via transcranial Doppler ultrasound, with concurrent measurements of mean arterial pressure (MAP) via finger photoplethysmography. The amplitude of MAP, CCAv, and MCAv oscillations in the low frequency range (LF; 0.07-0.15 Hz) were assessed via fast Fourier transformation, and normalized to total power (0.04-0.4 Hz) for each participant to account for high inter-individual variability. Relationships between R-wave-carotid PWV and LF variability in CCAv and MCAv were assessed via correlational analyses. Results: There were no between-group differences for R-wave-carotid PWV (MCI: 0.91±0.16 m/s vs. NC: 0.87±0.07 m/s; P=0.70), mean CCAv (MCI: 31.8±8.8 cm/s vs. NC: 29.7±2.0 cm/s; P=0.54), mean MCAv (MCI: 50.9±6.5 cm/s vs. NC: 47.9±12.7 cm/s; P=0.63), or MAP (MCI: 102.1±10.2 mmHg vs. 104.7±13.8 mmHg; P=0.73). While there was also no difference between groups for nLF power of CCAv (MCI: 0.28±0.03 au vs. NC: 0.33±0.10 au; P=0.41), nLF power for MCAv was lower in the MCI group (MCI: 0.26±0.07 au vs. 0.43±0.12; P=0.02). Overall, there was a strong positive correlation between R-wave-carotid PWV and CCAv nLF power (R=0.81, P=0.005), but a weaker relationship for MCAv nLF power (R=0.56, P=0.09). While sub-group correlational analyses are limited based on the small sample sizes, relationships between R-wave-carotid PWV and CCAv nLF power were high for both MCI (R=0.98, P=0.02) and NC (R=0.79, P=0.06) groups, but were lower for MCAv nLF power (MCI: R=-0.12, P=0.88; NC: R=0.69, P=0.13). Conclusion: Contrary to our hypothesis, there were no differences in R-wave-carotid PWV between groups, and blood flow variability was either similar between groups (for CCAv), or lower in the MCI group (for MCAv). Overall, there was a strong positive relationship between R-wave-carotid PWV and blood flow variability in the CCA, which was also observed in sub-analysis of the MCI and NC groups. Future investigations with a larger sample size are needed to definitively determine the role of arterial stiffness on cerebral blood flow variability with cognitive dysfunction.Item Comparing Framingham Cardiovascular Disease Risk Score and Cognitive Performance between Cognitive Normal Non-Hispanic Whites and Mexican American Elders(2020) O'Bryant, Sid; Johnson, Leigh; Vintimilla, Raul; Hall, James; Balasubramanian, KishorePurpose: To compare the relationship between Framingham Risk Scores and cognitive function between a cohort of Mexican-Americans (MAs) and Non-Hispanic Whites (NHWs). Methods: 518 cognitively normal participants (92 NHWs and 426 MAs) from the Health and Aging Brain Among Latino Elders study were studied. Demographic and clinical data relevant to Framingham Cardiovascular Disease 10-year Risk Score (FCVDRS) were assessed. FCVDRS was calculated based on BMI and categorized as Low if < 10, Moderate if between 10-20, and High if >20. Cognitive performance was evaluated using Trails B, Wechsler Logical Memory I and II, Mini Mental State Examination (MMSE), and Animal Naming (AN) tests. Demographic data was analyzed using t-tests and chi-square tests as appropriate. Pearson correlation tests and ANOVAs were used in comparing FCVDRS and FCVDRS categories against cognitive performance respectively. Results: MAs had significantly higher BMI, Systolic BP, and prevalence of Diabetes. Significantly higher proportion of NHWs were current smokers and were undergoing Hypertension treatment. Both cohorts were primarily female and had no significant difference in FCVDRS. Pearson Correlation Tests and ANOVAs were significant for Trails B, MMSE, and AN in MAs only. Tukey post-hoc tests showed significantly decreased performance for High-Risk groups when compared to Low-Risk groups in Trails B and when compared to Moderate-Risk risk groups in MMSE and AN. Conclusion: Mexican-Americans with High FCVDRS show decreased cognitive performance when compared to NHWs. FCVDRS could be used to identify high risk Mexican-Americans for early intervention.Item Losing the Protective Effect of Cognitive Aging in Mexican American Diabetics(2018-03-14) Gomez, Julie; Munoz, Haydee; Vintimilla, Raul; O'Jile, Judith; Johnson, Leigh; O'Bryant, Sid E.; Filipetto, FrancescaBackground: Diabetes is a serious health issue, affecting nearly 29 million people in the US. Mexican Americans (MA) have higher rates of diabetes, a risk factor for Alzheimer’s disease and mild cognitive impairment. Normal cognitive aging is associated with decline, not impairment, in some areas of cognition (processing speed, memory, etc). Diabetes may contribute to age associated cognitive decline and to the development of cognitive impairment. This study examines the effect of age on memory and executive functioning (EF) among diabetic and nondiabetic MA. Methods: Data from 415 MA subjects from the Health and Aging Brain among Latino Elders study (HABLE) were analyzed. Participants were classified as diabetic (n=171) or non-diabetic (n=244) and young (50 to 64, n=326) or old (65 and older, n=89). All participants were classified as normal controls (i.e., no diagnosis of dementia or MCI). Each participant underwent an interview (i.e., medical history and medications), cognitive testing, blood tests, and medical examination, as well as informant interviews. Memory was assessed by the Ravens Auditory Verbal Learning Test (RAVLT) Recognition and Delayed Recall, while EF was measured by Trail Making Test (TMT) Parts A&B and CLOX Part 1&2. Analyses were split by diabetes status (diabetic, non-diabetic) and age group (young, old), using independent t-tests. Results: Younger non-diabetic subjects scored significantly better than older non-diabetic subjects on measures of memory: RAVLT-Delayed Recall, t (3)=3.109, p=.002 , and executive functioning: TMT-A, t(56.450)=-3.529, p=.001, TMT-B, t(206)=-2.09, p=.004, and CLOX Part 2. Younger diabetic subjects scored significantly better than older diabetic subjects on measures of memory: RAVLT-Delayed Recall, t (109)=2.57, p=.012, and EF: TMT-A, t(44.177)=-2.257, p=.03, TMT-B, t(138)= -2.250, p=.026, and CLOX Part 2. Conclusion: It was expected that younger participants would perform better than older participants on all cognitive tests, regardless of diabetic status. However, the results indicated that younger and older diabetics demonstrated a similar pattern of performance on measures of memory and executive functioning, suggesting that younger age may no longer be a protective for diabetics. This study was limited by small sample size and cross sectional nature of the data. Further research is needed to understand the impact of health risks on normal cognitive aging.Item MRI biomarkers of small vessel disease and cognition: A cross-sectional study of a cognitively normal Mexican American cohort(Wiley Periodicals, LLC, 2021-10-14) Vintimilla, Raul; Hall, James R.; King, Kevin; Braskie, Meredith N.; Johnson, Leigh A.; Yaffe, Kristine; Toga, Arthur W.; O'Bryant, Sid E.Background: The current project sought to evaluate the impact that white matter hyperintensities (WMH) have on executive function in cognitively normal Mexican Americans, an underserved population with onset and more rapid progression of dementia. Methods: Data from 515 participants (360 female) enrolled in the Health and Aging Brain Study: Health Disparities project were analyzed. Participants underwent clinical evaluation, cognitive testing, and a brain MRI. Linear regression was used to predict the effect of total WMH volume on cognitive test scores. Age, sex, and education were entered as covariates. Results: Regression analysis showed that WMH volume significantly predicted executive function. WMH also predicted global cognition and attention scores, although not significantly after adjusting for age. Conclusion: In this sample of cognitively normal Mexican Americans, we found that WMH volume was associated with lower scores in a measure of executive function, after accounting for age, sex, and education.Item Prevalence of Metabolic Syndrome Components and other Cardiovascular Risk factors related to Cardiovascular Disease and Cognition: A Comparison between the HABLE and UNAM cohorts.(2019-03-05) Reyes, Miguel; Hall, James; Johnson, Leigh; O'Bryant, Sid E.; Vintimilla, RaulBackground: In the United States, the number two cause of death among Latinos in general, and Mexican Americans in particular is cardiovascular disease (CVD). Prevalence of major cardiovascular risk factors (CVRF) is higher among Mexican Americans than non-Hispanic Whites. Metabolic syndrome (MS) is a group of CFRF associated with greater risk of diabetes, CVD, cognitive decline, and dementia. Reports of CVRF prevalence among Mexico population and Mexican Americans living in the US have been contradictory. In general, it has been reported that the prevalence of CFRF in Mexico is within the range of what is observed in the US. A few comparative studies have demonstrated that US born and Mexico-born Mexicans Americans have higher prevalence that their Mexican counterparts. Also, some studies found that the only components of the metabolic syndrome with a higher prevalence in Mexico are total cholesterol and HDL. The purpose of this study was to compare the distribution of MS components among Mexican Americans from the Health and Aging Brain Among Latino Elders study (HABLE), with data from the National Autonomous University of Mexico (UNAM). Our goal was to gain a better insight about the similarities and differences in the prevalence of CVRF associated with metabolic syndrome in Mexicans and a cohort of Mexican Americans living in the United States (US). Methods: Data were analyzed in 290 participants (197 female), 60 years and older, from the ongoing HABLE study, and compared with data from a study done in 161 subjects (101 female), 60 years and older, at the UNAM. CVRF entered in the models included: fasting glucose, total cholesterol, HDL cholesterol, triglycerides, body mass index (BMI), abdominal circumference, and systolic and diastolic blood pressure. According to the National Cholesterol Education Program (ATP III), metabolic syndrome was defined as having 3 or more of the following: abdominal circumference ≥ 40 inches in males or ≥ 35 inches in females, triglycerides ≥ 150 mg/dl, HDL-Cholesterol Results: In both, male and female subjects, no significant difference was found for glucose and triglycerides levels among the two cohorts. . Between males, the UNAM cohort had higher levels of cholesterol (F=3.11, p=0.007), and HDL (F=1216.7, p2(1, N = 93) = 13.2, p = 0.0003 when comparing with males of the UNAM cohort. The difference in prevalence between females from both cohorts was not significant. Conclusion: In our study, with the exception of cholesterol and HDL, the prevalence of CVRF and metabolic syndrome was higher in urban dwelling Mexican Americans enrolled in the HABLE study than Mexicans enrolled in the UNAM study. Mexican Americans suffer a higher burden of CFRF andItem Quality of life in Medicaid patients 50 and over(2015-03) Large, Stephanie; Mathew, Susan; Richardson, Janice; Gamboa, Adriana; Vintimilla, Raul; Connally, Patrica; O'Jile, Judith R.; Johnson, Leigh; O'Bryant, SidIntroduction: Mighty Care is a community-based geriatric primary care program designed to reach Medicaid eligible adults and elders who are 50 and above, with the purpose of increasing access to care and improve patient quality of life. This is a new initiative for UNTHSC that utilizes mobile teams and clinics to increase access to care by providing appropriate levels of care within the community where the patients live. Generally, research indicates that as people age their quality of life (QOL) declines. The purpose of this study is to do a preliminary analysis of the QOL of the patients seen through this program, and examine age related differences in scores. Methods: QOL was assessed using the 36-item short form health survey (SF-36). The SF 36 is a widely used tool, and possesses good psychometric properties. The SF 36 consists of eight domains, which make up the physical and mental health composite scales. Descriptive statistics were calculated to compare the scores from our sample to the national means. To examine the impact of age, we split the sample into two groups: those 64 and under and 65 and older. Independent t test were used to examine the impact of the age groups on QOL scores. Results: The sample consisted of 229 patients (53 males and 176 females) with a mean age of 61. The average of PCS was 34.78 (SD= 9.87) and MCS was 45.075, falling slightly below the national average. For physical health there was a significant difference in the scores between the two groups, t (227) =-2.458, p=.015, with participants 64 and below (M= 33.7, SD=9.27) having lower scores that the 65 and above group (M=37.15, SD=10.84). For the mental health scores, there was a significant difference between the two groups, t (227)=-3.934, p= .000; suggesting that participants 64 and below (M= 42.71, SD= 13.66) had lower scores those over 65 (M=50.18, SD=12.18). Conclusion: Past research has indicated that age decreases scores on the physical and mental health scales. However, these results indicated that individuals 65 and older reported better QOL than their younger counterparts. One potential explanation for these findings has to do with the fact that at 65 most of these patients are able to apply for Medicare. All participants in this program have Medicaid, however as an individual reaches 65 they are considered dually eligible which means they can have both Medicare and Medicaid. This gives this population access to a wider array of health services and benefits. The data is from baseline QOL measures in the Mighty Care program. This study had a small sample size, therefore more data is needed.Item Recruiting elders into research(2019-03-05) Wong, Lillian; Izurieta, Haydee; Large, Stephanie; Ruiz, Daisy; Hall, James PhD; O'Bryant, Sid PhD; Johnson, Leigh; Vintimilla, RaulHypothesis/Objective Recruiting older adults into research is a complex task and utilizing ineffective recruitment methods is a waste of research grant money and researcher time. Research in aging and Alzheimer’s disease is particularly sensitive to low levels of enrollment and study completion, as it tends to have a higher participant burden (several study visits, time-consuming appointments and transportation issues). Enrolling sufficient participants is vital for the results of the study to be significant and representative of the population. The purpose of this study was to examine the most effective methods of recruitment in a cohort of adults 50 years or older. Methods The Health and Aging Brain Study among Latino Elders (HABLE) Study is a community based, epidemiological study of cognitive aging among Mexican American and non-Hispanic White elders. The study will recruit 1,000 Mexican Americans and 1,000 Non-Hispanic Whites. The HABLE study uses a combination of community based participatory research methods and targeted marketing for recruitment. On first contact, all participants are asked, “how did you hear about us?”; this information was compared with data from our outreach and advertising tracking system which includes information on the number and type of recruitment events (such as conferences, community talks, etc.), and marketing materials (such as postcards, paid advertisements, etc). Results The total number of new potential participant contacts was 2,136. Of that, 1038 (49%) were scheduled for a study visit; of those scheduled, 856 (82%) completed the study. The majority of participants reporting hearing about the study via: word of mouth (29%), print advertisement (19%) and community outreach at senior centers and churches (16%). Only a small fraction of participants heard about the research through free social media recruitment (1%) and health fair/conference/sponsorship (7%). Conclusions Out of all our recruitment strategies, word of mouth was the most effective. Additionally, print advertising (brochures, postcards and newspaper advertisements placed in various locations in the community) and community outreach in local senior centers or churches were highly successful. The data shows that a combination of mass advertising (print) and face-to-face recruitment (being present in community outreach events) is crucial in getting adults 50 years or older to enroll in aging research.Item Subjective memory complaints and cardiovascular risk factors: a cross-sectional study of the HABS-HD cohort(2022) Mathew, Ezek; Vintimilla, Raul; Hall, James; Johnson, Leigh; O'Bryant, SidBackground: Subjective memory complaints (SMC) are considered as subjects' interpretation of their cognitive aspects, such as memory and perception. Cardiovascular risk factors such as hypertension, diabetes, dyslipidemia, and obesity may contribute to cognitive decline and their relationship with dementia has been documented extensively. However, there is a lack of literature on the relationship between CVRFs and SMC. Depression has been linked to cardiovascular disease and it is strongly associated with SMC, so it is important to consider the contribution of CVRFs and depression as potentially modifiable factors of SMC. Despite the importance of SMC as a risk factor for cognitive decline, and the higher burden of CVRFs, cognitive decline and dementia among minorities like Mexican Americans (MA), not much attention has been paid to the study of SMC in this population. This study examined the factors associated with SMC in community-dwelling older MA and non - Hispanic Whites (NHW), particularly CVRFs and depression. We hypothesized that CVRFs will be associated with SMC, and that the association will be independent of depression. Methods: We studied 1,376 cognitively normal participants (673 MA and 673 NHW) from the Health and Aging Brain Study (HABS - HD). Baseline characteristics were analyzed using t and chi square tests. The presence of SMC was ascertained by the Subjective Memory Complaints Questionnaire (SCMQ). A logistic regression was conducted to examine the relationship of subjective memory complaints with CVRFs and depression. Age, gender, and education were entered as covariates in the model. Results: MA with SMC had a higher prevalence of dyslipidemia (p=0.008), and depression (p< 0.0001) than those without SMC. Fifty nine percent of the NHW sample were female. NHW with SMC were less educated than those without SMC (mean education years 15.26 vs 15.83), and have a higher prevalence of diabetes (p=0.04) and depression (p< 0.0001). When comparing baseline characteristics of MA (323) and NHW (269) with SMC, we found that MA were younger (mean age 63.74 vs 68.85) and less educated (mean education years 9.38 vs 15.26). MA with SMC had a higher prevalence of diabetes (p< 0.0001) and obesity (p=0.0001) when compared with NHW with SMC. Depression was strongly associated with SMC in MA (OR 3.46; 95% CI = 2.45 - 4.89) and NHW (OR 2.22; 95% CI = 1.59 - 3.10). Dyslipidemia was also associated with SMC in MA (OR 1.73; 95% CI = 1.25 - 2.40). NHW with less education had an increased likelihood of exhibiting SMC. Conclusions: Our findings suggest that the association of CVRF and SMC differs among MA and NHW. Depression was strongly associated with SMC in both groups. In MA, dyslipidemia was also associated with SMC in MA, while education was a significant factor only in NHW. The complex relationship between memory complains, vascular risk factors, and depression requires longitudinal studies for further clarification. Understanding SMC and its racial differences may allow early interventions to prevent cognitive decline.Item The Health & Aging Brain among Latino Elders (HABLE) study methods and participant characteristics(Wiley Periodicals, LLC, 2021-06-21) O'Bryant, Sid E.; Johnson, Leigh A.; Barber, Robert C.; Braskie, Meredith N.; Christian, Bradley; Hall, James R.; Hazra, Nalini; King, Kevin; Kothapalli, Deydeep; Large, Stephanie; Mason, David; Matsiyevskiy, Elizabeth; McColl, Roderick; Nandy, Rajesh; Palmer, Raymond; Petersen, Melissa E.; Philips, Nicole; Rissman, Robert A.; Shi, Yonggang; Toga, Arthur W.; Vintimilla, Raul; Vig, Rocky; Zhang, Fan; Yaffe, KristineIntroduction: Mexican Americans remain severely underrepresented in Alzheimer's disease (AD) research. The Health & Aging Brain among Latino Elders (HABLE) study was created to fill important gaps in the existing literature. Methods: Community-dwelling Mexican Americans and non-Hispanic White adults and elders (age 50 and above) were recruited. All participants underwent comprehensive assessments including an interview, functional exam, clinical labs, informant interview, neuropsychological testing, and 3T magnetic resonance imaging (MRI) of the brain. Amyloid and tau positron emission tomography (PET) scans were added at visit 2. Blood samples were stored in the Biorepository. Results: Data was examined from n = 1705 participants. Significant group differences were found in medical, demographic, and sociocultural factors. Cerebral amyloid and neurodegeneration imaging markers were significantly different between Mexican Americans and non-Hispanic Whites. Discussion: The current data provide strong support for continued investigations that examine the risk factors for and biomarkers of AD among diverse populations.Item The relationship of Hypertension and related Cardiovascular Risk factors to Executive Functioning in Mexican-Americans(2018-03-14) Hall, James; Johnson, Leigh; O'Bryant, Sid; Vintimilla, RaulBackground: The effect of high blood pressure on cognitive domains is unclear but the literature suggests that the primary impact is on cognitive impairment in executive functions and slowing of mental processing speed. These cognitive functions are especially vulnerable to vascular change. Hispanics are at increased risk for cardiovascular disease, cognitive decline and dementias, and there is no sufficient literature about this relationship in this growing segment of the population. The purpose of this study was to examine the link between blood pressure and executive functioning in Mexican-Americans. Methods: Data were analyzed in 426 participants from the Health and Aging Brain Among Latino Elders study (HABLE). Cardiovascular disease (CVD) risks include hypertension, dyslipidemia, diabetes mellitus, and abdominal circumference over 40 inches. The presence of these risks was determined from self-report, use of medication, and lab results. Trails B was used as an index of executive function and entered as the dependent variable in the models. A one-way ANOVA was conducted to assess the effect of CVD risk factors on executive function. Linear regressions were utilized to examine the relationship between hypertension and other CVD risk factors with executive function. Age was entered as a covariate in the model. Results: Within the total sample, ANOVA revealed a statically significance difference between groups (F (4,495) = 3.15, p = .01). The post hoc tests showed that the individuals with two (M = 7.7, SD = 3.7), three (M = 7.4, SD = 3.9) or four (M = 6.9, SD = 3.6) risk factors differ significantly at p B = -1.6, 95% CI [-2.36, -.80], p = .00). Hypertension explained a 4% of variance in Trails B scores, (R2 = .04, F (1,398) = 15.78, p = .00). None of the other CVD risk were significant. Conclusion: Our findings suggested a relationship between diagnosis of hypertension and executive function in Mexican-Americans. No other CVD risk factors independently had a significant link with executive function. Having more than one CVD risks regardless of its nature was related to lower executive functioning. The results of this study support literature that suggested that the effects of high blood pressure on cognitive domains primarily involve executive functioning.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.