Risk factors for MCI and dementia in a diverse senior cohort. Community-based research on mild cognitive impairment (MCI) and dementia includes relatively few longitudinal studies that include low-income minority seniors. PAR 15-356 specifically welcomes projects that propose augmenting existing longitudinal cohort studies, enhancing the power of multi- ethnic cohort studies, and exploring trends in the risk of Alzheimer's disease (AD). We propose to use intensive community-based outreach to recruit 800 seniors from a low-SES group of boroughs whose population is 60% African American (AA). These boroughs, comprising the 15104 ZIP code, are within the study area of MYHAT (R01AG023651), an ongoing population- based cohort study of cognitive impairment and dementia in 2000+ randomly selected seniors in southwestern PA. By using the MYHAT assessment protocol in the proposed new 15104 volunteer cohort, we will collect identical data and cost-effectively leverage the MYHAT data by pooling the two cohorts for analysis. Using appropriate sampling weights to adjust our estimates for non-random sample selection of the 15104 cohort, we will examine risk and resilience factors within the pooled cohort. We will identify factors associated with MCI at baseline, and, through annual follow-up assessments, identify risk factors for subsequent cognitive decline and dementia. Particularly, but not exclusively, we will focus on risk factors common among AA seniors: low education, poor educational quality, low health literacy, APOE*4 genotype, hypertension, diabetes, and smoking. We will then determine whether race modifies the relationship between risk factors and adverse cognitive outcomes. Enhancing the participation of minority seniors will allow us to take a critical first step towards addressing the challenges of investigating, and eventually addressing, cognitive health disparities in the population.
Between 2006 and 2008, we assembled a community-based cohort of over 2,000 adults, aged 65+ years, by randomly selecting individuals from the Voter Registration lists for a group of small towns municipalities in a Rust Belt area of southwestern Pennsylvania . The study is called the Monongahela- Youghiogheny Healthy Aging Team (MYHAT). We now propose to use intensive community outreach within 3 towns in the same area, with enthusiastic support from the town Mayors, to recruit a sample of 800 volunteers who are 60% African Americans. We will work with community leaders to inform seniors in these towns about the MYHAT study and encourage their participation. Using appropriate statistical weighting methods, we will combine the new sample with the MYHAT sample. The knowledge generated will inform clinical and public health strategies for prevention of cognitive decline and dementia in older minority adults, and potentially influence health policy and planning.
