Observational Study
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World J Neurol. Jun 28, 2014; 4(2): 7-11
Published online Jun 28, 2014. doi: 10.5316/wjn.v4.i2.7
Variation in risk factors of dementia among four elderly patient cohorts
Baqar Husaini, Van Cain, Meggan Novotny, Zahid Samad, Robert Levine, Majaz Moonis
Baqar Husaini, Van Cain, Meggan Novotny, Zahid Samad, Center For Prevention Research, Tennessee State University, Nashville, TN 37209, United States
Robert Levine, Department of Preventive and Family Medicine, Meharry Medical College, Nashville, TN 37208, United States
Majaz Moonis, Stroke Center, Department of Neurology, University of Massachusetts, Memorial Hospital, Worcester, MA 01655, United States
Author contributions: Husaini B, Levine R and Moonis M wrote the main manuscript text; Cain V and Novotny M prepared Tables and Figure 1; Samad Z was involved with discussion development; all authors reviewed the manuscript.
Supported by Tennessee State University: CDC, No. ED072081100; NCI, No. 5U54CA163066; by a NIH(National Center on Minority Health and Health Disparity to Meharry Medical College), No. P20MD000516
Correspondence to: Baqar Husaini, PhD, Professor Emeritus, Director Emeritus, Center For Preventive Research, Tennessee State University, 3500 John Merritt Blvd, Nashville, TN 37209, United States. bhusaini@tnstate.edu
Telephone: +1-615-2101132 Fax: +1-615-9635068
Received: April 8, 2014
Revised: May 7, 2014
Accepted: June 14, 2014
Published online: June 28, 2014
Abstract

AIM: To examine variation in risk factors that contributed to dementia among four elderly cohorts by race and gender.

METHODS: We examined 2008 Tennessee Hospital Discharged database for vascular factors that play a role in both stroke and dementia. Risk factors for dementia were examined for black and white patients aged 65+. Four race-gender groups of patients-white males (WM), black males (BM), white females (WF), and black females (BF) were compared for prevalence of dementia and stroke. A logistic model predicting dementia in each group separately used several vascular factors affecting dementia directly or indirectly through stroke.

RESULTS: Three point six percent of patients hospitalized in 2008 had dementia and dementia was higher among females than males (3.9% vs 3.2%, P < 0.001), and higher among blacks than whites (4.2% vs 3.5%, P < 0.000). Further, BF had higher prevalence of dementia than WF (4.2% vs 3.8%, P < 0.001); similarly BM had more dementia than WM (4.1% vs 3.1%, P < 0.001). In logistic regression models, however, different patterns of risk factors were associated with dementia in four groups: among WF and WM, hypertension, diabetes, congestive heart failure, and stroke predicted dementia. Among BF and BM, only stroke and diabetes were related to dementia.

CONCLUSION: Aggressive management of risk factors (hypertension and diabetes) may subsequently reduce stroke and dementia hospitalization.

Keywords: Dementia, Race, Gender, Stroke, Vascular factors

Core tip: Large medicaid in-hospital database that examines the differences in prevalence of dementia amongst blacks and white population and by gender. Clear differences emerge; blacks have greater burden of dementia including both genders. Risk factors leading to dementia differed between groups. White males and females had a higher association with stroke, hypertension, heart failure and diabetes while blocks had stroke and diabetes only as risk factors. This difference allows us to target these 2 groups with aggressive management early on to reduce the risk of dementia. The strength lies in analyzing a very large database to derive these conclusions.