Neuropathological Lesions and Cognitive Abilities in Black and White Older Adults in Brazil.

Autor:	Suemoto CK; Division of Geriatrics, University of Sao Paulo Medical School, Sao Paulo, Sao Paulo, Brazil., Leite REP; Division of Geriatrics, University of Sao Paulo Medical School, Sao Paulo, Sao Paulo, Brazil., Paes VR; Department of Pathology, University of Sao Paulo Medical School, Sao Paulo, Sao Paulo, Brazil., Rodriguez R; Department of Neurology University of Sao Paulo Medical School, Sao Paulo, Sao Paulo, Brazil., Justo AFO; Division of Geriatrics, University of Sao Paulo Medical School, Sao Paulo, Sao Paulo, Brazil., Naslavsky MS; Human Genome and Stem Cell Center, Biosciences Institute, University of Sao Paulo, Sao Paulo, Sao Paulo, Brazil., Zatz M; Human Genome and Stem Cell Center, Biosciences Institute, University of Sao Paulo, Sao Paulo, Sao Paulo, Brazil., Pasqualucci CA; Department of Pathology, University of Sao Paulo Medical School, Sao Paulo, Sao Paulo, Brazil., Nitrini R; Department of Neurology University of Sao Paulo Medical School, Sao Paulo, Sao Paulo, Brazil., Ferriolli E; Division of Geriatrics, University of Sao Paulo Medical School, Sao Paulo, Sao Paulo, Brazil., Jacob-Filho W; Division of Geriatrics, University of Sao Paulo Medical School, Sao Paulo, Sao Paulo, Brazil., Grinberg LT; Department of Pathology, University of Sao Paulo Medical School, Sao Paulo, Sao Paulo, Brazil.; Memory and Aging Center, University of San Francisco, San Francisco, California.; Global Brain Health Institute, University of San Francisco, San Francisco, California.
Jazyk:	angličtina
Zdroj:	JAMA network open [JAMA Netw Open] 2024 Jul 01; Vol. 7 (7), pp. e2423377. Date of Electronic Publication: 2024 Jul 01.
DOI:	10.1001/jamanetworkopen.2024.23377
Abstrakt:	Importance: Race differences in dementia prevalence and incidence have previously been reported, with higher dementia burden in Black decedents. However, previous neuropathological studies were conducted mostly in convenience samples with White participants; conducting clinicopathological studies across populations is crucial for understanding the underlying dementia causes in individuals from different racial backgrounds. Objective: To compare the frequencies of neuropathological lesions and cognitive abilities between Black and White Brazilian adults in an autopsy study. Design, Setting, and Participants: This cross-sectional study used samples from the Biobank for Aging Studies, a population-based autopsy study conducted in Sao Paulo, Brazil. Participants were older adults whose family members consented to the brain donations; Asian participants and those with missing data were excluded. Samples were collected from 2004 to 2023. Neuropathologists were masked to cognitive outcomes. Exposure: Race as reported by the deceased's family member. Main Outcomes and Measures: The frequencies of neurodegenerative and cerebrovascular lesions were evaluated in 13 selected cerebral areas. Cognitive and functional abilities were examined with the Clinical Dementia Rating Scale. Results: The mean (SD) age of the 1815 participants was 74.0 (12.5) years, 903 (50%) were women, 617 (34%) were Black, and 637 (35%) had cognitive impairment. Small vessel disease (SVD) and siderocalcinosis were more frequent in Black compared with White participants (SVD: odds ratio [OR], 1.74; 95% CI, 1.29-2.35; P < .001; siderocalcinosis: OR, 1.70; 95% CI, 1.23-2.34; P = .001), while neuritic plaques were more frequent in White compared with Black participants (OR, 0.61; 95% CI, 0.44-0.83; P = .002). Likewise, Alzheimer disease neuropathological diagnosis was more frequent in White participants than Black participants (198 [39%] vs 77 [33%]), while vascular dementia was more common among Black participants than White participants (76 [32%] vs 121 [24%]). Race was not associated with cognitive abilities, nor did it modify the association between neuropathology and cognition. Conclusions and Relevance: In this cross-sectional study of Brazilian older adults, Alzheimer disease pathology was more frequent in White participants while vascular pathology was more frequent in Black participants. Further neuropathological studies in diverse samples are needed to understand race disparities in dementia burden.
Databáze:	MEDLINE
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