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Disparate Dementia Risk Factors Are Associated with Cognitive Impairment and Rates of Decline in African Americans
Christian Lachner, Emily C. Craver, Ganesh Muneshwar Babulal, John Alexander Lucas, Tanis J. Ferman, Richard O. White, Neill R. Graff‐Radford, Gregory Scott Day. Annals of Neurology, 2023-12-09
Topic: Risk, prevention and care in population studies
Hypertension, hypercholesterolemia, obesity, and diabetes were overrepresented in AA participants, but were not associated with cognitive impairment. Depression was associated with increased odds of cognitive impairment in AA (odds ratio [OR] = 4.30, 95% confidence interval [CI] = 2.13-8.67) and nHW participants (OR = 2.79, 95% CI = 1.21-6.44) but uniquely associated with faster decline in AA participants (β = 1.71, 95% CI = 0.69-2.73, p = 0.001). Fewer AA participants reported antidepressant use (9/49, 18%) than nHW counterparts (57/78, 73%, p < 0.001). Vitamin B12 deficiency was also associated with an increased rate of cognitive decline in AA participants (β = 2.65, 95% CI = 0.38-4.91, p = 0.023). Modifiable dementia risk factors are common in AA and nHW participants, representing important risk mitigation targets. Depression was associated with dementia in AA and nHW participants, and with accelerated declines in cognitive function in AA participants. Optimizing depression screening and treatment may improve cognitive trajectories and outcomes in AA participants. ANN NEUROL 2024;95:518-529.
Key findings
- Hypertension, hypercholesterolemia, obesity, and diabetes were overrepresented in AA participants, but were not associated with cognitive impairment.
- Depression was associated with increased odds of cognitive impairment in AA (odds ratio [OR] = 4.30, 95% confidence interval [CI] = 2.13-8.67) and nHW participants (OR = 2.79, 95% CI = 1.21-6.44) but uniquely associated with faster decline in AA participants (β = 1.71, 95% CI = 0.69-2.73, p = 0.001).
- Fewer AA participants reported antidepressant use (9/49, 18%) than nHW counterparts (57/78, 73%, p < 0.001).
- Vitamin B12 deficiency was also associated with an increased rate of cognitive decline in AA participants (β = 2.65, 95% CI = 0.38-4.91, p = 0.023).
- Modifiable dementia risk factors are common in AA and nHW participants, representing important risk mitigation targets.
Why it matters
This study found that depression was linked to cognitive impairment in African American and non-Hispanic White participants, and uniquely linked to faster cognitive decline in African American participants, who also reported less antidepressant use. It suggests that better depression screening and treatment may improve cognitive outcomes, but it does not test a dementia cure or prevention.
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Study details
- Participants261
- Effect sizeOR = 2.79
- Evidence strengthLow
How this study scored 50/100
Published in a leading specialty journal. Scored zero for study design and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Annals of Neurology) |
| Journal's citation record | 3 / 4 | Annals of Neurology: journal h-index 437 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 3 / 5 | 2023 — within 6 year(s) of the newest study here |
| Sample size | 2 / 4 | 261 participants |
| Effect reported | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 2 / 7 | Cited 12 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 2.4 citations a year over 5 year(s) since 2023 |
| Impact for its field and year | 2 / 6 | Cited 2.2× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 1 / 6 | Cited by 2 other studies in this library |
| Still being cited | 1 / 4 | Cited 12 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Gregory Scott Day: h-index 43 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | Washington University in St. Louis: institution h-index 1,962 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 38069571) |
| Free to read | 2 / 2 | Free to read |
| Total | 50 / 100 | — |
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Read the original
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 8 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
APA 7th
Lachner, C., Craver, E. C., Babulal, G. M., Lucas, J. A., Ferman, T. J., White, R. O., et al. (2023). Disparate Dementia Risk Factors Are Associated with Cognitive Impairment and Rates of Decline in African Americans. Annals of Neurology. https://doi.org/10.1002/ana.26847
Vancouver
Lachner C, Craver EC, Babulal GM, Lucas JA, Ferman TJ, White RO, et al. Disparate Dementia Risk Factors Are Associated with Cognitive Impairment and Rates of Decline in African Americans. Annals of Neurology. 2023. doi:10.1002/ana.26847. PMID: 38069571.
BibTeX
@article{lachner2023-38069571,
author = {Lachner, Christian and Craver, Emily C. and Babulal, Ganesh Muneshwar and Lucas, John Alexander and Ferman, Tanis J. and White, Richard O. and Graff‐Radford, Neill R. and Day, Gregory Scott},
title = {{Disparate Dementia Risk Factors Are Associated with Cognitive Impairment and Rates of Decline in African Americans}},
journal = {Annals of Neurology},
year = {2023},
doi = {10.1002/ana.26847},
pmid = {38069571},
url = {https://doi.org/10.1002/ana.26847}
}
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