Impact of Dementia Risk Factors: Variations by Race and Ethnicity Revealed

Introduction: An emerging body of research emphasizes the influence of modifiable health conditions, such as high blood pressure, obesity, and type 2 diabetes, on the risk of developing dementia. However, a recent study published in the journal PLoS One underscores that these risk factors are far from universal and may affect individuals differently based on their racial or ethnic backgrounds.

New Study Unveils Disparities: This study has uncovered not only a higher prevalence of certain dementia risk factors among Black and South Asian adults when compared to their white counterparts but also varying degrees of impact associated with these risk factors.

Dr. Naaheed Mukadam, the lead author of the study and a researcher at the University College London in England, emphasizes the significance of these findings, stating, "This is a truly groundbreaking discovery that has not been previously acknowledged."

The Growing Concern of Dementia: Dementia, characterized by the loss of cognitive functioning, is becoming an increasingly pressing issue as populations age worldwide. A study in The Lancet Public Health in January 2022 projected a doubling of the number of adults living with dementia in the United States by 2050, from approximately 5 to 10 million. Nevertheless, experts suggest that preventive measures could potentially reduce up to 40 percent of dementia cases.

Challenges in Research: One notable challenge highlighted by the authors is that many studies on modifiable dementia risk factors have primarily focused on white adults of European descent. Dr. Mukadam emphasizes the necessity of personalized approaches to dementia prevention and management, recognizing that a one-size-fits-all strategy may not be suitable for everyone.

Hypertension-Dementia Link: Disparities Unveiled: To investigate risk factors and dementia onset across a diverse population, the research team analyzed anonymized data from UK primary care records spanning from 1997 to 2018, involving nearly 900,000 adults.

During this period, over 12 percent of the study's population developed dementia, with notable variations among different ethnic groups. The researchers closely examined the data to identify dementia risk factors, including hypertension, obesity, hearing loss, diabetes, smoking, depression, alcohol excess, dyslipidemia (high total cholesterol), low levels of HDL ("good" cholesterol), high levels of LDL ("bad" cholesterol), sleep disorders, and traumatic brain injury.

Key Findings: The study revealed that certain risk factors had a stronger association with a heightened risk of dementia among Black and South Asian individuals compared to white individuals, particularly those related to cardiovascular health.

• Hypertension (high blood pressure) was found to be linked with a higher risk of dementia in Black individuals compared to white individuals, even after adjusting for various factors such as age, sex, education, income, and neighborhood. • Hypertension, obesity, diabetes, low HDL, and sleep disorders were associated with an increased risk of dementia in South Asian individuals. • Compared to their white counterparts, hypertension had 1.57 times more impact on dementia risk in South Asian individuals and 1.18 times more impact in Black individuals.

These findings may offer insights into previous observations of greater susceptibility, an earlier onset of dementia, and reduced survival rates following a dementia diagnosis within minority ethnic groups.

The Need for Further Research: This study holds significant importance both from a social justice perspective and within the scientific community. Dr. Kyan Younes, a clinical assistant professor and researcher at Stanford Medicine, emphasizes the need for inclusive research for the benefit of the entire population.

The next step involves unraveling the underlying causes of these racial and ethnic disparities. Dr. Younes suggests that multiple factors, including exposures, access to healthcare, and health literacy, may contribute to varying risk levels. Future research focusing on these "why" questions can lead to more equitable and tailored dementia prevention efforts.

Consulting Your Healthcare Provider: In light of these findings, it is recommended that patients discuss their risk factors for dementia with their healthcare providers. Dr. Albert Lai, a neurologist and researcher at UCLA Health, suggests that patients inquire about more aggressive treatment or surveillance for dementia, if deemed necessary.

Dr. Mukadam further advises considering brain health alongside cardiovascular health and regularly monitoring hearing and blood pressure. Incorporating healthy habits into one's life, especially in midlife, can contribute to dementia risk reduction.