In search of an ethno-culturally appropriate approach for the early identification of Cognitive Impairment in African Americans

Emory University, Atlanta GA

Investigators

Linked publications, trials & patents

Abstract

PROJECT/SUMMARY ABSTRACT Completion of the projects outlined will serve as the foundation for my career's focus on studying factors that are involved in both cognitive and functional disparity and identifying the optimal methodology to assess both in African Americans (AA). We propose to test, in a cohort of 330 study participants with prodromal Alzheimer Dementia (AD) (at least 40% AA) whether quickly administered tests of executive vs. global function will 1) better correlate with measures of day-to-day function; 2) more strongly correlate with progression to dementia; and 3) be mediated by vascular diseases, namely hypertension (HTN). 1. To identify the optimal cognitive marker that best predicts functional impairment in older AA. A1?Sub aim: To determine whether impairment in executive function is superior to memory recall in predicting functional impairment in older community-dwelling African Americans. Hypothesis 1: Compared to White participants, among older community-dwelling AA, measures of executive function will better predict functional outcomes than memory recall-based cognitive assessments alone. A2?Sub aim:To determine whether impairment in executive function is associated with future cognitive and functional decline in older community-dwelling AA and is to a greater extent than for Whites. Hypothesis 2: Compared to White participants, among older community-dwelling AA, measures of executive function will better predict future cognitive and functional decline than memory recall-based cognitive assessments alone. 2. To investigate the role of HTN, key vascular risk factor, in cognitive function disparity as measured NIHTB-CB & CLOX1 as well as global function measures (MoCA) among the aforementioned groups. Hypothesis 3: Greater prevalent HTN will partially explain the disparity between AA and Whites in global and executive function. The funding of the projects and activities outlined in this application will serve as critical ?startup? resources that will 1) underwrite the development of a local research infrastructure for the Principal Investigator (PI); 2) provide fundamental research skill improvement; and 3) protect time for relevant projects and the writing of manuscripts to disseminate findings. This proposal builds on earlier work toward identifying a cognitive assessment method that is simultaneously and significantly correlated with function, having practical extension and use in primary care for the early identification of cognitive impairment in older community-dwelling African Americans. The data and experience obtained from completing the projects in this proposal will serve as preliminary data for a planned application to further investigate factors in racial disparity in cognitive and functional impairments.