Sociodemographic Correlates of Cognition in the Multi-Ethnic Study of Atherosclerosis (MESA)

Annette L Fitzpatrick; Stephen R Rapp; José Luchsinger; Felicia Hill-Briggs; Alvaro Alonso; Rebecca Gottesman; Hochang Lee; Mercedes Carnethon; Kiang Liu; Kayleen Williams; A Richey Sharrett; Alexis Frazier-Wood; Constantine Lyketsos; Teresa Seeman

doi:10.1016/j.jagp.2015.01.003

Sociodemographic Correlates of Cognition in the Multi-Ethnic Study of Atherosclerosis (MESA)

Am J Geriatr Psychiatry. 2015 Jul;23(7):684-97. doi: 10.1016/j.jagp.2015.01.003. Epub 2015 Jan 20.

Authors

Affiliations

¹ Departments of Family Medicine, Epidemiology, and Global Health, University of Washington, Seattle, WA. Electronic address: fitzpal@u.washington.edu.
² Department of Psychiatry and Behavioral Medicine, Wake Forest University School of Medicine, Winston-Salem, NC.
³ Departments of Medicine and Epidemiology, Columbia University Medical Center, New York, NY.
⁴ Departments of Medicine and Health, Behavior and Society, Johns Hopkins Medical Institutions, Baltimore, MD.
⁵ Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN.
⁶ Department of Cerebrovascular Neurology, Johns Hopkins Hospital, Baltimore, MD.
⁷ Psychological Medicine Service, Yale University School of Medicine, New Haven, CT.
⁸ Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL.
⁹ Department of Biostatistics, University of Washington, Seattle, WA.
¹⁰ Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
¹¹ USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX.
¹² Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD.
¹³ Departments of Medicine and Epidemiology, University of California, Los Angeles, CA.

Abstract

Objective: 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.

Design: Cross-sectional measurements of a prospective observational cohort.

Setting: Residents of 6 U.S. communities free of cardiovascular disease at baseline (2000-02).

Participants: 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.

Measurements: 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. Demographic, socioeconomic, and cultural covariates were also collected for descriptive statistics and multivariate modeling.

Results: 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.

Conclusion: 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.

Keywords: MESA; cognition; methods; multi-ethnic; race; socioeconomic.

Publication types

Observational Study
Research Support, N.I.H., Extramural

MeSH terms

Aged
Aged, 80 and over
Atherosclerosis / ethnology*
Cognition*
Cross-Sectional Studies
Culture
Ethnicity / statistics & numerical data*
Female
Humans
Male
Middle Aged
Multivariate Analysis
Prospective Studies
Psychological Tests
Racial Groups
Residence Characteristics
Risk Factors
Socioeconomic Factors
United States
White People / statistics & numerical data*

Abstract

Publication types

MeSH terms

Grants and funding