The National Health and Aging Trends Study (NHATS) estimates that 11.2% of Americans ? 65 have probable dementia (1). The Marshallese are a subpopulation of Pacific Islanders with the highest concentration of the migrants settled in Northwest Arkansas that are experiencing significant health disparities. Some of the co-morbidities such as type 2 diabetes have been studied by McElfish et al but cognitive impairment or dementia in this population has not been investigated. Dementia, regardless of etiology, imposes a severe socioeconomic burden on society and at an individual level on the patient, the caregiver(s), and families. Race, ethnicity and migrant with lower health literacy might all influence dementia prevalence in the Marshallese population. Given the fast growing numbers of Marshallese with extremely high rates of T2DM (38.4%), pre-diabetes (32.6%) and hypertension (40%) it is imperative that investigators and healthcare providers give attention to brain health and dementia. The prevalence and associated cardiometabolic, social and genetic risk factors for cognitive impairment need to be investigated in the Marshallese in order to design, offer and deliver public health services, resources and medical care in an appropriate and culturally sensitive manner. Our innovation resides in: a) evaluating for the first time the understanding of dementias and cognitive impairment among the Marshallese community, b) determining for the first time the prevalence of cognitive impairment in the Marshallese population; c) determining how the risk factors for dementia including APOE genotype, hypertension and diabetes mellitus correlate with cognition. We would like to investigate Alzheimer disease and related dementias in the Marshallese through the following specific aims:
Aim 1 a To evaluate the perceptions of Marshallese residents towards memory loss or dementia and to provide information and education to bridge the knowledge gap;
Aim 1 b To test the hypothesis that older Marshallese residents (over age 55 years) with diabetes and hypertension will have more cognitive impairment compared to that in their age matched cohorts without diabetes or hypertension.
Aim 2 : To determine the prevalence of APOE4 vs. APOE2 or APOE3 genotype in the older Marshallese residents in Northwest Arkansas and correlate it with their cognitive function.
In this proposal we aim to find out the prevalence of Alzheimer disease and related dementias in the Marshallese population. We also to plan to obtain data on the attitude, perceptions and knowledge base of the older adult Marshallese regarding dementia and cognitive impairment. We will compare the memory of Marshallese with diabetes mellitus and hypertension with those without diabetes and hypertension. Finally, we will analyze the common APOE gene in Marshallese that are associated with a risk of Alzheimer disease.
