The long-term goal of this research is to address two important health disparities faced by Mexican Americans suffering from Alzheimer's disease (AD) and mild cognitive impairment (MCI): (1) younger age of onset and (2) decreased access to early detection and treatment. AD is the most common form of neurodegenerative dementia and the 5th leading cause of death for those over 65 (8th leading cause of death for U.S. Hispanics). AD has an annual health care cost that is greater than that of cardiovascular disease (CVD) and cancer. While death rates from CVD and cancer have declined in recent decades, death rates have steadily increased for AD. The Mexican American elderly population is among the fastest growing segments of the population; however, little research on MCI and AD has been conducted among this underserved group. Here we will leverage our ongoing Health & Aging Brain among Latino Elders (HABLE) study to identify different pathways for MCI and AD among Mexican Americans, define subtle neuroanatomical and blood-based biomarker changes that are related to future risk of MCI and AD as well as provide evidence to support the utility of our AD blood-based detection tool that can be implemented in primary care settings. The current research team consists of leading experts in Mexican American cognitive aging, the epidemiology of MCI and AD as well as biomarkers of MCI and AD (neuroimaging and blood-based). The project will leverage a substantial existing infrastructure and HABLE cohort to address the two health disparities outlined above through the following specific aims:
Specific Aim 1 - Examine the impact of higher rates of metabolic burden and depressive symptomatology on MCI and AD among community-dwelling Mexican Americans;
Specific Aim 2 - Examine neuroimaging and blood-based biomarkers associated with MCI and AD among Mexican Americans;
and Specific Aim 3 : Validate our blood-based AD screening tool as the first-step in a multi-stage diagnostic process among Mexican Americans. The current project will address significant health disparities faced by Mexican American elders suffering from and at risk for MCI and AD. The identification of novel pathways related to disproportionate burden of diabetes and depression can lead to novel ethnic-specific interventions. The identification of a blood-based screening tool for AD will provide primary care providers a way of meeting the needs of a rapidly growing elderly Mexican American population.

Public Health Relevance

Despite the rapidly growing number of patients suffering from Alzheimer's (AD), little work has been conducted on AD among Mexican Americans. Here we propose to address two important health disparities faced by Mexican Americans suffering from AD (1) younger age of onset and (2) decreased access to early diagnosis methods. The relevance of this project is the identification of potentially different pathways to AD among Mexican Americans (directly related to increased rates of diabetes and depression and the health disparity of earlier age of onset) as well as the provision of a blood-based screening tool for AD that can be implemented in primary care clinics.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Research Project (R01)
Project #
5R01AG054073-04
Application #
9936114
Study Section
Special Emphasis Panel (ZRG1)
Program Officer
Elliott, Cerise
Project Start
2017-09-01
Project End
2022-05-31
Budget Start
2020-06-01
Budget End
2021-05-31
Support Year
4
Fiscal Year
2020
Total Cost
Indirect Cost
Name
University of North Texas
Department
Internal Medicine/Medicine
Type
Schools of Osteopathic Medicine
DUNS #
110091808
City
Fort Worth
State
TX
Country
United States
Zip Code
76107
Hall, James R; Balldin, Valerie Hobson; Gamboa, Adriana et al. (2018) Texas Mexican American adult normative studies: Normative data for the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Dev Neuropsychol 43:27-35
Hall, James R; Wiechmann, April; Johnson, Leigh A et al. (2018) Characteristics of Cognitively Normal Mexican-Americans with Cognitive Complaints. J Alzheimers Dis 61:1485-1492
O'Bryant, Sid E; Edwards, Melissa; Johnson, Leigh et al. (2018) Texas Mexican American adult normative studies: Normative data for commonly used clinical neuropsychological measures for English- and Spanish-speakers. Dev Neuropsychol 43:1-26
Gavett, Brandon E; Stypulkowski, Katie; Johnson, Leigh et al. (2018) Factor structure and measurement invariance of a neuropsychological test battery designed for assessment of cognitive functioning in older Mexican Americans. Alzheimers Dement (Amst) 10:536-544
Babulal, Ganesh M; Quiroz, Yakeel T; Albensi, Benedict C et al. (2018) Perspectives on ethnic and racial disparities in Alzheimer's disease and related dementias: Update and areas of immediate need. Alzheimers Dement :