Year: 2021
Type: article
Study design: Observational Study
Abstract: Objective: Compared to European Americans, research indicates that African Americans have higher white matter hyperintensity (WMH) load; however, the clinical and biological bases underlying this higher burden are poorly understood. We hypothesize that obesity may explain differences in WMH between African and European Americans. Methods: Participants enrolled in longitudinal brain aging studies (n=292; 61% Female; 92% European American; mean age=69.6± 7.7) completed evaluations including medical exams, neuroimaging, and sociodemographic surveys. Overweight/obese status defined as body mass index ≥ 30 kg/m 2 , and WMH load, captured by FLAIR images, as sum of deep and periventricular volumes, scored using the Fazekas scale (0– 6), WMH≥ 4 considered high. Results: Logistic regression analyses, adjusted for age, sex, hypertension, and smoking history, indicated that age and interaction between race and obesity were significant predictors of WMH, demonstrating that obesity significantly moderated the relationship between race and WMH. Age independently increased the odds of high WMH by 16% (OR=1.16, 95% CI=1.09– 1.23, p< 0.001). Stratified analysis indicates that older European Americans had increased WMH (OR=1.17, 95% CI=1.09– 1.23, p< 0.001), while obese African Americans had increased WMH (OR=27.65, 95% CI=1.47– 519.13, p< 0.05). In a case controlled subgroup matched by age, sex, and education (n=48), African Americans had significantly higher WMH load (27% vs 4%, &KHgr; 2 =5.3, p=0.02). Conclusion: Results denote that age predicted WMH among European Americans, while obesity predicted WMH among African Americans. Matched sample analyses indicate that obesity increases the odds of WMH, though more pronounced in African Americans. These findings suggest that obesity may explain the differential burden of white matter hyperintensity load, signifying public health and clinical importance. Keywords: white matter hyperintensities, WMH, racial/ethnic differences, African American, obesity
Source: Clinical Interventions in Aging
DOI: 10.2147/cia.s316064
Institutions: New York University, Weill Cornell Medicine
Language: English
Subfield: Clinical Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,836
Awards: Alzheimer's Disease Research Center, Biomarkers in Early Alzheimer's Disease (AD)., Hypertension, brain clearance and markers of neurodegeneration, PET Measures of CSF Clearance in Preclinical Alzheimer's Disease, The effect of insufficient sleep on cardiovascular disease disparity between blacks and whites, MRI Progression Markers of Cognitive Decline in the Elderly, CSF Clearance with 11C-Butanol PET Predicts Amyloid Deposition, G652135642, Mechanisms of sleep deficiency and effects on brain injury and neurocognitive functions among older blacks, Determinants of insufficient sleep among blacks and effects on disparities in health outcomes, Sleep Aging and Risk for Alzheimer's disease-Resubmission-1, Tailored Peer-Based Sleep Health Education and Social Support in Blacks with OSA, DORMIR: Determinants, Outcomes, Responses and Markers of Insufficient sleep in Rural-Urban settings, Clinical Correlates of Longitudinal PET Changes in AD, Enhancing Leadership Capacity to Mentor Scientists in Translational Behavioral AD-Related Research (K07), G9000268221, Anatomy of the circle of Willis, cerebral blood flow, and Alzheimer's disease biomarkers in hypertension, Program to Increase Diversity in Behavioral Medicine and Sleep Disorders Research, The mediating role of Slow Wave Sleep and Vascular Risk Factors on Alzheimer Disease related disparity between African-Americans and non-Hispanic Whites
OpenAlex ID: W3194131243