Stroke, cognitive impairment and dementia are increasing public health problems with a disproportionate impact on blacks and Hispanics. The National Alzheimer's Project Act and the NIH have recommended more extensive studies on the risk and determinants of dementia in disparities populations. Elucidation of the relationships between traditional and novel vascular risk factors for stroke, dementia, cognitive impairment, and disability is critical to enhance our ability to modify the risk of these conditions. The Northern Manhattan Study consists of a population-based cohort of 3497 stroke-free adults who have been followed annually for a median of 13.9 years. This collaborative prospective cohort study among whites, blacks, and Caribbean Hispanics living in the same community is an outstanding resource to address health disparities involving faculty across three institutions (Columbia University, University of Miami, and the Icahn School of Medicine at Mount Sinai). The cohort is well characterized and the 1290 subjects among the MRI sub-cohort have had a standardized brain MRI and two neuropsychological assessments over 5 years. The new aims are to determine the relationship between cognitive trajectories and a novel neuro-immune and inflammatory biomarker panel; determine the relationship between brain imaging biomarkers (regional brain volumes, regional white matter lesion burden, hippocampal volumes, cortical thickness, small dilated perivascular spaces, dolichoectasia) and cognitive trajectories and dementia; determine the risk and vascular determinants of dementia; characterize the vascular determinants of functional impairment, disability, and quality of life; and assess the relationship between novel risk factors and specific ischemic stroke subtypes. To accomplish these aims, subjects will continue to be followed annually by telephone to ascertain stroke, MI, death and change in cognitive status, and more extensive functional assessments will be collected. A third expanded in-person neuropsychological assessment will be done among the MRI subcohort and a dementia consensus conference will ascertain and classify dementia. Stored plasma at the time of MRI will be used to measure an innovative inflammatory and immune biomarker panel, and new MRI measures will be analyzed on the already collected brain MRIs. The strengths of this prospective cohort study are the wealth of baseline data already assembled, the tri-ethnic composition residing in the same community, the outstanding follow-up record, the evaluation of novel serum biomarkers and brain imaging biomarkers, and the expanded focus on comprehensive outcomes including cognitive trajectories, dementia, functional impairment, and ischemic stroke subtypes. The results of these studies will be instrumental in the design of intervention programs to prevent stroke and cognitive decline in diverse populations and be a valuable shared data resource.

Public Health Relevance

Stroke and dementia are increasing public health problems with a larger impact on blacks and Hispanics. Results from studying new blood and brain imaging factors will be instrumental in proposing interventions to prevent stroke and dementia in minority populations.

National Institute of Health (NIH)
National Institute of Neurological Disorders and Stroke (NINDS)
Research Project (R01)
Project #
Application #
Study Section
Neurological, Aging and Musculoskeletal Epidemiology (NAME)
Program Officer
Moy, Claudia S
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
University of Miami School of Medicine
Schools of Medicine
Coral Gables
United States
Zip Code
Dhamoon, Mandip S; Cheung, Ying-Kuen; Gutierrez, Jose et al. (2018) Functional Trajectories, Cognition, and Subclinical Cerebrovascular Disease. Stroke 49:549-555
Della-Morte, David; Dong, Chuanhui; Markert, Matthew S et al. (2018) Carotid Intima-Media Thickness Is Associated With White Matter Hyperintensities: The Northern Manhattan Study. Stroke 49:304-311
Della-Morte, David; Gardener, Hannah; Dong, Chuanhui et al. (2018) Association Between Carotid Artery Function and Structure in the Northern Manhattan Study. Front Neurol 9:246
Willey, Joshua Z; Moon, Yeseon P; Dhamoon, Mandip S et al. (2018) Regional Subclinical Cerebrovascular Disease Is Associated with Balance in an Elderly Multi-Ethnic Population. Neuroepidemiology 51:57-63
Dhamoon, Mandip S; Cheung, Ying-Kuen; Bagci, Ahmet et al. (2018) Periventricular White Matter Hyperintensities and Functional Decline. J Am Geriatr Soc 66:113-119
Dueker, Nicole D; Guo, Shengru; Beecham, Ashley et al. (2018) Sequencing of Linkage Region on Chromosome 12p11 Identifies PKP2 as a Candidate Gene for Left Ventricular Mass in Dominican Families. G3 (Bethesda) 8:659-668
Kulick, Erin R; Wellenius, Gregory A; Boehme, Amelia K et al. (2018) Residential Proximity to Major Roadways and Risk of Incident Ischemic Stroke in NOMAS (The Northern Manhattan Study). Stroke 49:835-841
Baird, Stacy W; Jin, Zhezhen; Okajima, Kazue et al. (2018) Relationship between body mass and ambulatory blood pressure: comparison with office blood pressure measurement and effect of treatment. J Hum Hypertens 32:122-128
Dhamoon, Mandip S; Cheung, Ying-Kuen; DeRosa, Janet T et al. (2018) Association Between Subclinical Brain Infarcts and Functional Decline Trajectories. J Am Geriatr Soc 66:2144-2150
Ahn, Soohyun; Lim, Johan; Paik, Myunghee Cho et al. (2018) Cox model with interval-censored covariate in cohort studies. Biom J 60:797-814

Showing the most recent 10 out of 214 publications