The Association of Subjective Cognitive Decline and Demographic, Social, Clinical, and Neuropsychological Factors in the HABS-HD Cohort

dc.creatorJohnson, Darrianen_US
dc.description.abstractBackground: The number of people with Alzheimer’s Disease and Related Dementias (ADRD) is projected to double by 2060 with the greatest increases in Hispanics. Mexican Americans experience an earlier onset of Alzheimer’s disease, but research shows that the illness is diagnosed much later in their lives. Sociodemographic projections predict a larger percentage of Hispanics with subjective cognitive decline (SCD) in the future. SCD is related to cognitive decline and dementia risk. This study will explore how SCD is associated with sociodemographic and clinical factors along with cognitive performance amongst Mexican Americans (MA) and non-Hispanic white (NHW) participants of the Health and Aging Brain – Health Disparities Study (HABS -HD). Methods: The HABS-HD is a longitudinal study led by the Institute for Translational Research at the University of North Texas Health Science Center. A cross-sectional analysis of data from (n=1342) cognitively normal participants aged 30 years and older was performed. The cohort (662 NHW and 690 MA) underwent a clinical interview to collect information on depression, anxiety, and co-morbidities, neurocognitive and functional examinations, brain MRI, amyloid and tau PET scans, and blood collection for biomarker review. Worry and perceived social support were evaluated using the Penn State Worry Questionnaire (PSWQ) while subjective cognitive decline was assessed using the Subjective Memory Complaints Questionnaire. Neighborhood socioeconomic status (NSES) was measured using the national area deprivation index (ADI) percentile ranking composed of education, employment, income, occupation, and housing. Global cognition was graded using the Mini-Mental State Examination (MMSE) and memory was assessed using the logical memory 1 and 2 tests. Statistical analysis was based on binary logistic regression using SCD as the dependent variable and was stratified by ethnicity with sex, age, education, and BMI as co-variants. Results: SCD was present in 49% of the sample.MA were younger, less educated, more likely to live in the most deprived neighborhoods, and had less social support (p≤0.005) In addition, they were more likely to be depressed and diabetic along with having a higher Body Mass Index (BMI) and experiencing more SCD than NHW (p≤0.005). MMSE scores were lower in in MA (p≤0.005). When looking at the logistic regression, model 1 confirmed associations of SCD with age and GDS scores in NHW, and MA. After adjustment for cognitive scores, only GDS remained significant in both races. MA living in the most deprived neighborhoods had 2.45 more chance to present SCD than those living in the least deprived neighborhoods (95% CI 1.15 to 5.19). There was no difference in NHW. Conclusion: Our study showed that individuals with a higher degree of SCD were more likely to live in high ADI neighborhoods. The idea of SCD as a proxy for objective memory impairment and AD faces many barriers in minorities. However, while chronic stress and depression burden vulnerable communities, it is possible that SCD may serve as an indicator for future cognitive impairment and prompt the establishment of strategies to address these issues in neighborhoods influenced by inequitable circumstances.en_US
dc.titleThe Association of Subjective Cognitive Decline and Demographic, Social, Clinical, and Neuropsychological Factors in the HABS-HD Cohorten_US