Background: African American and Hispanic older adults are reported to have up to a 2-fold higher risk of Alzheimer's disease and related disorders (ADRD), but the reasons for this increased vulnerability have not been fully explored. The Vulnerability Index (VI) was designed to identify individuals who are at risk of developing cognitive impairment in the future, capturing 12 sociodemographic variables and modifiable medical comorbidities associated with higher ADRD risk. However, a prior limitation of the VI was that the original study cohort had limited diversity. We examined the association of the VI within and between non-Hispanic White, African American, and Hispanic older adults with and without cognitive impairment and different socioeconomic strata enrolled in a community-based dementia screening study.
Objective: To explore reasons for reported higher ADRD vulnerability in African Americans and Hispanics.
Methods: In a cross-sectional study of 300 non-Hispanic White, African American, and Hispanic older adults with and without cognitive impairment, we studied the association between cognitive status, the VI, and socioeconomic status (SES).
Results: When considering race/ethnicity, the presence of more vascular comorbidities drove greater vulnerability. When considering SES, vascular comorbidities played a less prominent role suggesting resources and access to care drives risk. The VI had differential effects on cognitive performance with the greatest effect in the earlier stages of impairment.
Conclusion: Findings from this study provide a deeper understanding of the differential risk of ADRD in multicultural older adults captured by the VI and how barriers to healthcare access may increase vulnerability in racial/ethnic minorities.
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http://dx.doi.org/10.3233/JAD-220959 | DOI Listing |
Medicine (Baltimore)
January 2025
Department of Gastroenterology, The Affiliated People's Hospital of Ningbo University, Ningbo, China.
Rationale: Gastric antral vascular ectasia (GAVE) is a rare acquired lesion characterized by vascular dilation in the gastric antrum, frequently results in occult or overt gastrointestinal bleeding. Endoscopic intervention remains the cornerstone of therapy. Argon plasma coagulation was previously considered a first treatment option.
View Article and Find Full Text PDFMedicine (Baltimore)
January 2025
Department of Neurology (Nerve-Muscle Unit), Reference Center for Neuromuscular Diseases "AOC," ALS Reference Center, University Hospitals of Bordeaux (Pellegrin Hospital), University of Bordeaux, Bordeaux, France.
Rationale: Locked-in syndrome (and its variant, completely locked-in state) generally has a high mortality rate in the acute setting; however, when induced by conditions such as acute inflammatory polyradiculoneuropathy, it may well be curable such that an attempt at cure should be systematically sought by clinicians.
Patient Concerns: A 52-year-old man presented with acute tetraparesia and areflexia, initially diagnosed as Guillain-Barré syndrome. Despite appropriate treatment, his condition deteriorated, evolving into a completely locked-in state.
Medicine (Baltimore)
January 2025
Zhengzhou Central Hospital Affiliated to Zhengzhou University, Henan, China.
Inflammatory responses and lipid metabolism disorders are key components in the development of coronary artery disease and contribute to no-reflow after coronary intervention. This study aimed to investigate the association between the neutrophil to high-density lipoprotein ratio (NHR) and no-reflow phenomenon in ST-segment elevation myocardial infarction (STEMI) patients after primary percutaneous coronary intervention (PPCI). This study enrolled 288 patients with STEMI from September 1st, 2022 to February 29th, 2024, in the Zhengzhou Central Hospital Affiliated to Zhengzhou University.
View Article and Find Full Text PDFMedicine (Baltimore)
January 2025
Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.
This study explores the relationship between 25-hydroxyvitamin D/calcium/alkaline phosphatase (ALP) levels and kidney stone development via cross-sectional and Mendelian randomization (MR) analyses. We used data from the National Health and Nutrition Examination Survey (NHANES) 2013 to 2018 to explore the associations of 25(OH)D metabolite, calcium, and ALP levels with kidney stone development, LDSC analysis to determine the associations between their genetically predicted levels and kidney stone development, and MR analysis to determine the causality of those relationship via genome-wide association studies (GWASs). The cross-sectional study revealed a relationship between ALP levels and kidney stone development (Model 1: OR = 1.
View Article and Find Full Text PDFMedicine (Baltimore)
January 2025
Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Rationale: Traumatic pseudoaneurysm of the sinus of Valsalva (PSV) is a rare but life-threatening condition, often resulting from blunt chest trauma. Rapid progress and a high risk of rupture highlight the importance of prompt diagnosis and intervention. We present a case of a rare pseudoaneurysm linked to the right coronary sinus after blunt chest trauma.
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