Pathways explaining racial/ethnic and socio-economic disparities in dementia incidence: the UK Biobank Study

Beydoun, M. A., Beydoun, H. A., Fanelli-Kuczmarski, M. T., Weiss, J., Georgescu, M. F., Meirelles, O., Lyall, D. , Evans, M. K. and Zonderman, A. B. (2023) Pathways explaining racial/ethnic and socio-economic disparities in dementia incidence: the UK Biobank Study. Aging, 15(18), pp. 9310-9340. (doi: 10.18632/aging.205058) (PMID:37751591) (PMCID:PMC10564412)

Abstract

Background: Pathways explaining racial/ethnic disparities in dementia risk are under-evaluated. Methods: We examine those disparities and their related pathways among UK Biobank study respondents (50–74 y, N = 323,483; 3.6% non-White minorities) using a series of Cox proportional hazards and generalized structural equations models (GSEM). Results: After ≤15 years, 5,491 all-cause dementia cases were diagnosed. Racial minority status (RACE_ETHN, Non-White vs. White) increased dementia risk by 24% (HR = 1.24, 95% CI: 1.07–1.45, P = 0.005), an association attenuated by socio-economic status (SES), (HR = 1.12, 95% CI: 0.96–1.31). Total race-dementia effect was mediated through both SES and Life’s Essential 8 lifestyle sub-score (LE8LIFESTYLE), combining diet, smoking, physical activity, and sleep factors. SES was inversely related to dementia risk (HR = 0.69, 95% CI: 0.67, 0.72, P < 0.001). Pathways explaining excess dementia risk among racial minorities included ‘RACE_ETHN(−) → SES(−) → DEMENTIA’, ‘RACE_ETHN(−) → SES(−) → Poor cognitive performance, COGN(+) → DEMENTIA’ and ‘RACE_ETHN(−) → SES(+) → LE8LIFESTYLE(−) → DEMENTIA’. Conclusions: Pending future interventions, lifestyle factors including diet, smoking, physical activity, and sleep are crucial for reducing racial and socio-economic disparities in dementia.

• Item Type: Articles
• Additional Information: This research was supported entirely by the Intramural Research Program of the NIH, National Institute on Aging (Z01-AG000513).
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Lyall, Dr Donald
• Authors: Beydoun, M. A., Beydoun, H. A., Fanelli-Kuczmarski, M. T., Weiss, J., Georgescu, M. F., Meirelles, O., Lyall, D., Evans, M. K., and Zonderman, A. B.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health
• Journal Name: Aging
• Publisher: Impact Journals
• ISSN: 1945-4589
• ISSN (Online): 1945-4589
• Copyright Holders: Copyright: © 2023 Beydoun et al.
• First Published: First published in Aging 15(18): 9310—9340
• Publisher Policy: Reproduced under a Creative Commons licence