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

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Suemoto, Claudia K. ; Leite, Renata E. P. ; Paes, Vitor R. ; Rodriguez, Roberta ; Justo, Alberto F. O. ; Naslavsky, Michel S. ; Zatz, Mayana ; Pasqualucci, Carlos A. ; Nitrini, Ricardo ; Ferriolli, Eduardo ; Jacob-Filho, Wilson ; Grinberg, Lea T.
Número total de Autores: 12
Tipo de documento: Artigo Científico
Fonte: JAMA NETWORK OPEN; v. 7, n. 7, p. 12-pg., 2024-07-25.
Resumo

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. (AU)

Processo FAPESP: 12/07526-5 - Doença por grãos argirofílicos
Beneficiário:Roberta Diehl Rodriguez
Modalidade de apoio: Bolsas no Brasil - Doutorado Direto
Processo FAPESP: 21/14171-8 - O papel das óxido nítrico sintases na doença de alzheimer
Beneficiário:Alberto Fernando Oliveira Justo
Modalidade de apoio: Bolsas no Brasil - Pós-Doutorado
Processo FAPESP: 09/09134-4 - A reserva cognitiva em uma população com escolaridade reduzida
Beneficiário:Wilson Jacob Filho
Modalidade de apoio: Auxílio à Pesquisa - Regular