The prevalence and incidence rates of dementia appear to be increasing in recent decades but an understanding of the etiology and prevention of much dementia remains unexplored. Increased interest in the contribution of cardiovascular risk factors to dementia has led the investigators to consider a study in older Latinos. Although older Latinos have a number of health conditions and risk factors that predispose them for dementia, no studies have examined even simple prevalence and incidence rates of dementia in this group. Rapid increases in the numbers and proportions of cognitively and physical impaired elderly in the U.S. have lead to increased concerns about the impact of these changes on use of health services and the burden of chronic disease. Older Latinos have increased by 35% since 1970, almost three times the rate of non-Latino whites. Latinos have higher levels of diabetes, hypertension and obesity, all conditions which increase the risk of dementia as well as cognitive and physical impairments. Elderly Latinos also appear to have a higher prevalence rate of functional impairments as measured in cross-sectional studies by ADLs/IADLs compared to non-Latinos. Little is known about patterns of decline in cognitive or physical functioning in elderly Latinos or about the risk factors that influence such declines. There is a serious lack of information on culturally appropriate approaches to cognitive assessment and on psychosocial and physical risk factors influencing physical and cognitive function among elderly Latinos. The proposed research will follow for two years a cohort of 2000 community-dwelling Latinos aged 60 and over in three counties located in the Central Valley of California. The study provides a unique opportunity to obtain important data on health status, prevalence of functional impairments, risk factors for decline in physical and cognitive function and the prevalence and incidence rates of dementia in this growing group of elderly. As a population-based study, it will provide more accurate, generalizable data on many aspects of health and functioning in the Latino elderly. It will also examine the associations between diabetes, hypertension, obesity and other cardiovascular risk factors and conditions and cognitive and physical functioning. It will estimate the prevalence and incidence rates of dementia and examine the association between these risk factors and dementia. The investigators have developed a set of neuropsychological tests which are based on preliminary work with this population and are designed to afford a more accurate method of ascertaining cognitive impairments and dementias in Latinos. The investigators have already spent three years successfully investigating cognitive and physical functioning in this group. The investigative team is multidisciplinary and highly experienced in research in epidemiology, neurology, cardiovascular disease, and cognitive sciences.
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