The mediating role of systemic inflammation and moderating role of racialization in disparities in incident dementia.

Autor: Higgins Tejera C; School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA. chiggi25@jh.edu.; Department of Neurology, Division of Neuroimmunology and Neurological Infections, Johns Hopkins University, 600 N Wolfe St, Baltimore, MD, 21287, USA. chiggi25@jh.edu., Ware EB; Institute for Social Research, University of Michigan, 426 Thompson St, 48104, Ann Arbor, MI, USA., Hicken MT; Institute for Social Research, University of Michigan, 426 Thompson St, 48104, Ann Arbor, MI, USA., Kobayashi LC; School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA., Wang H; School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA., Blostein F; Vanderbilt University, 2525 West End Avenue, 37203, Nashville, TN, USA., Zawistowski M; School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA., Mukherjee B; School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA., Bakulski KM; School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA.
Jazyk: angličtina
Zdroj: Communications medicine [Commun Med (Lond)] 2024 Jul 13; Vol. 4 (1), pp. 142. Date of Electronic Publication: 2024 Jul 13.
DOI: 10.1038/s43856-024-00569-w
Abstrakt: Background: Exposure to systemic racism is linked to increased dementia burden. To assess systemic inflammation as a potential pathway linking exposure to racism and dementia disparities, we investigated the mediating role of C-reactive protein (CRP), a systemic inflammation marker, and the moderating role of the racialization process in incident dementia.
Methods: In the US Health and Retirement Study (n = 6,908), serum CRP was measured at baseline (2006, 2008 waves). Incident dementia was classified by cognitive tests over a six-year follow-up. Self-reported racialized categories were a proxy for exposure to the racialization process. We decomposed racialized disparities in dementia incidence (non-Hispanic Black and/or Hispanic vs. non-Hispanic white) into 1) the mediated effect of CRP, 2) the moderated portion attributable to the interaction between racialized group membership and CRP, and 3) the controlled direct effect (other pathways through which racism operates).
Results: The 6-year cumulative incidence of dementia is 12%. Among minoritized participants (i.e., non-Hispanic Black and/or Hispanic), high CRP levels ( ≥ 75 th percentile or 4.73μg/mL) are associated with 1.26 (95%CI: 0.98, 1.62) times greater risk of incident dementia than low CRP ( < 4.73μg/mL). Decomposition analysis comparing minoritized versus non-Hispanic white participants shows that the mediating effect of CRP accounts for 3% (95% CI: 0%, 6%) of the racial disparity, while the interaction effect between minoritized group status and high CRP accounts for 14% (95% CI: 1%, 27%) of the disparity. Findings are robust to potential violations of causal mediation assumptions.
Conclusions: Minoritized group membership modifies the relationship between systemic inflammation and incident dementia.
(© 2024. The Author(s).)
Databáze: MEDLINE
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