Racial/ethnic disparities in risk and protective factors of dementia: a lifespan approach

Abstract We examined risk and protective factors associated with dementia and decomposed racial/ethnic disparities in factors associated with dementia. We performed a retrospective analysis of 3,495 individuals 65+ who participated in the 2016 Harmonized Cognitive Assessment Protocol, linked to Health and Retirement Study. Using the MMSE score, individuals were classified as having dementia vs cognitively normal. Risk factors included cardiovascular factors and hearing loss in midlife, current smoking, depression, and physical inactivity. Protective factors included educational attainment and wealth. Using Oaxaca-Blinder decomposition we quantified the relative contribution of individual variables in explaining racial/ethnic disparities. We found that Blacks and Hispanics have higher dementia risk compared to Whites. Accounting for demographics, mid-and later-life risk and protective factors explained one-third of the difference in Blacks and Whites’ cognitive functioning, and two-thirds of the difference in Hispanics and Whites. The findings highlight disparate dementia rates, and the need to elucidate other factors beyond race/ethnicity.