Redefining Dementia Disparities: A Closer Look at Race and Lifestyle
Dementia, a decline in cognitive function that affects daily life, has been observed to disproportionately affect racial minorities. This research delves into the disparities in dementia incidence, particularly focusing on racial and socio-economic factors. The UK Biobank study, which included over 323,000 respondents, found that racial minorities had a 24% higher risk of developing dementia compared to their white counterparts. Interestingly, this risk was somewhat reduced when socio-economic status (SES) was taken into account. The study also highlighted the significant role of lifestyle factors, termed as "Life's Essential 8 lifestyle sub-score (LE8LIFESTYLE)", which encompasses diet, smoking, physical activity, and sleep. These factors, when combined with SES, play a pivotal role in understanding the higher dementia risk among racial minorities. In essence, leading a healthier lifestyle and addressing socio-economic disparities could be key in reducing the prevalence of dementia across different racial groups.
Article Information
Pathways explaining racial/ethnic and socio-economic disparities in dementia incidence: the UK Biobank study
Aging (Albany NY). May A Beydoun et al.
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.
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