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The Mediating Role of Systemic Inflammation and Moderating Role of Race/Ethnicity in Racialized Disparities in Incident Dementia: A Decomposition Analysis. | LitMetric

AI Article Synopsis

  • - The study investigates how systemic racism contributes to dementia disparities by examining inflammation markers, specifically C-reactive protein (CRP), and their effects on different racial/ethnic groups.
  • - In a sample of over 5,000 participants, results showed that high CRP levels were linked to a 27% increased risk of developing dementia among non-Hispanic Black and Hispanic individuals compared to those with lower CRP levels.
  • - The analysis revealed that CRP mediated 2% of the racial disparity in dementia risk, while an additional 12% was attributed to the interaction between high CRP levels and being part of a minoritized racial group, highlighting systemic inflammation's role in these disparities.

Article Abstract

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 race/ethnicity on racialized disparities in incident dementia.

Methods: In the US Health and Retirement Study (n=5,143), 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 was 15.5%. Among minoritized participants (i.e., non-Hispanic Black and/or Hispanic), high CRP levels (> 75 percentile or 4.57μg/mL) was associated with 1.27 (95%CI: 1.01,1.59) times greater risk of incident dementia than low CRP (≤4.57μg/mL). Decomposition analysis comparing minoritized versus non-Hispanic White participants showed that the mediating effect of CRP accounted for 2% (95% CI: 0%, 6%) of the racial disparity, while the interaction effect between minoritized group status and high CRP accounted for 12% (95% CI: 2%, 22%) of the disparity. Findings were robust to potential violations of causal mediation assumptions.

Conclusions: Systemic inflammation mediates racialized disparities in incident dementia.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10081405PMC
http://dx.doi.org/10.1101/2023.03.22.23287593DOI Listing

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