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Title: Sociodemographic correlates of cognition in the multi-ethnic study of atherosclerosis (MESA)

Author
item FITZPATRICK, ANNETTE - University Of Washington
item RAPP, STEPHEN - Wake Forest School Of Medicine
item LUCHSINGER, JOSE - Columbia University Medical Center
item HILL-BRIGGS, FELICIA - Johns Hopkins University
item ALONSO, ALVARO - University Of Minnesota
item GOTTESMAN, REBECCA - Johns Hopkins University School Of Medicine
item LEE, HOCHANG - Yale School Of Medicine
item CARNETHON, MERCEDES - Northwestern University
item LIU, KIANG - Northwestern University
item WILLIAMS, KAYLEEN - University Of Washington
item SHARRETT, RICHEY - Johns Hopkins School Of Public Health
item FRAZIER-WOOD, ALEXIS - Children'S Nutrition Research Center (CNRC)
item LYKETSOS, CONSTANTINE - Johns Hopkins University
item SEEMAN, TERESA - University Of California

Submitted to: The American Journal of Geriatric Psychiatry
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 1/13/2015
Publication Date: 7/1/2015
Citation: Fitzpatrick, A.L., Rapp, S.R., Luchsinger, J., Hill-Briggs, F., Alonso, A., Gottesman, R., Lee, H., Carnethon, M., Liu, K., Williams, K., Sharrett, R., Frazier-Wood, A., Lyketsos, C., Seeman, T. 2015. Sociodemographic correlates of cognition in the multi-ethnic study of atherosclerosis (MESA). The American Journal of Geriatric Psychiatry. 23(7):684-697.

Interpretive Summary: The Multi-Ethnic Study of Atherosclerosis (MESA) is a longitudinal study designed to better understand the causes and consequences of subclinical atherosclerosis. The baseline exam (Exam 1) was conducted around 2005, and at Exam 5 data on cognitive ability was collected for the first time. The goal of this paper was to describe the methodology utilized to evaluate cognitive function in and to present preliminary results by age, gender and race/ethnicity. We found that associations between socio-economic factors and cognitive functioning revealed that age, race/ethnicity, education, current occupational status, household income, health insurance type, household size, place of birth, years in U.S., generations in U.S., and the presence of a specific allele were significantly associated with performance on the cognitive tests although patterns varied by specific test, racial/ethnicity, and socio-cultural factors. These data provide a baseline understanding and description which will inform future MESA exams and more comprehensive analyses of the contributions of subclinical and clinical diseases to cognitive function and decline.

Technical Abstract: Our objective was to describe the methodology utilized to evaluate cognitive function in the Multi-Ethnic Study of Atherosclerosis (MESA) and to present preliminary results by age, sex, and race/ethnicity. Cross-sectional measurements of a prospective observational cohort. Residents of 6 U.S. communities free of cardiovasculardisease at baseline (2000-02). 4,591 adults who completed the fifth MESA clinical examination in 2011-12; mean age 70.3 (SD: 9.5) years, 53.1% women, 40.7% non-Hispanic white, 26.4% non-Hispanic black, 21.4% Hispanic, and 11.5% Chinese. The cognitive battery consisted of the Cognitive Abilities Screening Instrument (version 2) to evaluate global cognition, the Digit Symbol Code for processing speed and Digit Spans Forward and Backward to assess memory. The demographic, socioeconomic, and cultural covariates were also collected for descriptive statistics and multivariate modeling. Associations between socioeconomic factors and cognition revealed that age, race/ethnicity, education, occupational status, household income, health insurance type, household size, place of birth, years and generation in U.S., and the presence of the ApoE4 allele were significantly associated with performance on the cognitive tests, although patterns varied by specific test, racial/ethnicity, and sociocultural factors. As many of the influencing cultural and socioeconomic factors measured here are complex, multifactorial, and may not be adequately quantified, caution has been recommended with regard to comparison and interpretation of racial/ethnic group performance differences from these cross-sectional models. These data provide a baseline for future exams and more comprehensive longitudinal analyses of the contributions of subclinical and clinical diseases to cognitive function and decline.