Send these researchers back to the drawing board because there is no such thing as race as far as the body is concerned. Go back and find the real reason for distinguishing them. This is just a crutch used to not do the hard work of finding out the real reason.
Association Between Blood Pressure and Later-Life Cognition Among Black and White Individuals
Deborah A. Levine, MD, MPH1,2,3; Alden L. Gross, PhD4; Emily M. Briceño, PhD5; et al
Nicholas Tilton, PhD1; Mohammed U. Kabeto, MS1; Stephanie M. Hingtgen, MPP1; Bruno J. Giordani, PhD6; Jeremy B. Sussman, MD, MS1,3,7; Rodney A. Hayward, MD1,3,7; James F. Burke, MD, MS2,3,7; Mitchell S. V. Elkind, MD, MS8,9; Jennifer J. Manly, PhD8,10; Andrew E. Moran, MD, MPH11; Erin R. Kulick, PhD12; Rebecca F. Gottesman, MD, PhD13; Keenan A. Walker, PhD13; Yuichiro Yano, MD, PhD14; Darrell J. Gaskin, PhD15; Stephen Sidney, MD, MPH16; Kristine Yaffe, MD17,18,19; Ralph L. Sacco, MD, MS20; Clinton B. Wright, MD, MS21; Veronique L. Roger, MD, MPH22; Norrina Bai Allen, PhD23; Andrzej T. Galecki, MD, PhD1,24
JAMA Neurol. Published online April 13, 2020. doi:10.1001/jamaneurol.2020.0568
Full Text
Key PointsQuestion
Do black individuals’ higher cumulative blood pressure levels
contribute to their greater risk of cognitive impairment and dementia
compared with white individuals?
Findings In this pooled cohort analysis of 19 378 participants, black individuals, compared with white individuals, had significantly faster declines in global cognition. Differences between black and white individuals in global cognition decline were no longer statistically significant after adjusting for cumulative mean systolic blood pressure.
Meaning Black individuals’ higher cumulative blood pressure levels may explain racial disparities in cognitive decline.
Importance
Black individuals are more likely than white individuals to
develop dementia. Whether higher blood pressure (BP) levels in black
individuals explain differences between black and white individuals in
dementia risk is uncertain.
Objective To determine whether cumulative BP levels explain racial differences in cognitive decline.
Design, Setting, and Participants Individual participant data from 5 cohorts (January 1971 to December 2017) were pooled from the Atherosclerosis Risk in Communities Study, Coronary Artery Risk Development in Young Adults Study, Cardiovascular Health Study, Framingham Offspring Study, and Northern Manhattan Study. Outcomes were standardized as t scores (mean [SD], 50 [10]); a 1-point difference represented a 0.1-SD difference in cognition. The median (interquartile range) follow-up was 12.4 (5.9-21.0) years. Analysis began September 2018.
Main Outcomes and Measures The primary outcome was change in global cognition, and secondary outcomes were change in memory and executive function.
Exposures Race (black vs white).
Results Among 34 349 participants, 19 378 individuals who were free of stroke and dementia and had longitudinal BP, cognitive, and covariate data were included in the analysis. The mean (SD) age at first cognitive assessment was 59.8 (10.4) years and ranged from 5 to 95 years. Of 19 378 individuals, 10 724 (55.3%) were female and 15 526 (80.1%) were white. Compared with white individuals, black individuals had significantly faster declines in global cognition (−0.03 points per year faster [95% CI, −0.05 to −0.01]; P = .004) and memory (−0.08 points per year faster [95% CI, −0.11 to −0.06]; P < .001) but significantly slower declines in executive function (0.09 points per year slower [95% CI, 0.08-0.10]; P < .001). Time-dependent cumulative mean systolic BP level was associated with significantly faster declines in global cognition (−0.018 points per year faster per each 10–mm Hg increase [95% CI, −0.023 to −0.014]; P < .001), memory (−0.028 points per year faster per each 10–mm Hg increase [95% CI, −0.035 to −0.021]; P < .001), and executive function (−0.01 points per year faster per each 10–mm Hg increase [95% CI, −0.014 to −0.007]; P < .001). After adjusting for cumulative mean systolic BP, differences between black and white individuals in cognitive slopes were attenuated for global cognition (−0.01 points per year [95% CI, −0.03 to 0.01]; P = .56) and memory (−0.06 points per year [95% CI, −0.08 to −0.03]; P < .001) but not executive function (0.10 points per year [95% CI, 0.09-0.11]; P < .001).
Conclusions and Relevance These results suggest that black individuals’ higher cumulative BP levels may contribute to racial differences in later-life cognitive decline.
Findings In this pooled cohort analysis of 19 378 participants, black individuals, compared with white individuals, had significantly faster declines in global cognition. Differences between black and white individuals in global cognition decline were no longer statistically significant after adjusting for cumulative mean systolic blood pressure.
Meaning Black individuals’ higher cumulative blood pressure levels may explain racial disparities in cognitive decline.
Abstract
Objective To determine whether cumulative BP levels explain racial differences in cognitive decline.
Design, Setting, and Participants Individual participant data from 5 cohorts (January 1971 to December 2017) were pooled from the Atherosclerosis Risk in Communities Study, Coronary Artery Risk Development in Young Adults Study, Cardiovascular Health Study, Framingham Offspring Study, and Northern Manhattan Study. Outcomes were standardized as t scores (mean [SD], 50 [10]); a 1-point difference represented a 0.1-SD difference in cognition. The median (interquartile range) follow-up was 12.4 (5.9-21.0) years. Analysis began September 2018.
Main Outcomes and Measures The primary outcome was change in global cognition, and secondary outcomes were change in memory and executive function.
Exposures Race (black vs white).
Results Among 34 349 participants, 19 378 individuals who were free of stroke and dementia and had longitudinal BP, cognitive, and covariate data were included in the analysis. The mean (SD) age at first cognitive assessment was 59.8 (10.4) years and ranged from 5 to 95 years. Of 19 378 individuals, 10 724 (55.3%) were female and 15 526 (80.1%) were white. Compared with white individuals, black individuals had significantly faster declines in global cognition (−0.03 points per year faster [95% CI, −0.05 to −0.01]; P = .004) and memory (−0.08 points per year faster [95% CI, −0.11 to −0.06]; P < .001) but significantly slower declines in executive function (0.09 points per year slower [95% CI, 0.08-0.10]; P < .001). Time-dependent cumulative mean systolic BP level was associated with significantly faster declines in global cognition (−0.018 points per year faster per each 10–mm Hg increase [95% CI, −0.023 to −0.014]; P < .001), memory (−0.028 points per year faster per each 10–mm Hg increase [95% CI, −0.035 to −0.021]; P < .001), and executive function (−0.01 points per year faster per each 10–mm Hg increase [95% CI, −0.014 to −0.007]; P < .001). After adjusting for cumulative mean systolic BP, differences between black and white individuals in cognitive slopes were attenuated for global cognition (−0.01 points per year [95% CI, −0.03 to 0.01]; P = .56) and memory (−0.06 points per year [95% CI, −0.08 to −0.03]; P < .001) but not executive function (0.10 points per year [95% CI, 0.09-0.11]; P < .001).
Conclusions and Relevance These results suggest that black individuals’ higher cumulative BP levels may contribute to racial differences in later-life cognitive decline.
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