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The Hachinski ischemic scale and cognition: the influence of ethnicity
Leigh A Johnson1, Blair Cushing, Geoffrey Rohlfing
1Department of Internal Medicine, University of North Texas Health Sciences Center, Fort Worth, TX, USA.
Insights
The Hachinski Ischemic Scale (HIS) effectively identifies cognitive dysfunction in non-Hispanic Whites but shows less utility for diagnosing mild cognitive impairment (MCI) in Mexican Americans, highlighting ethnic differences in vascular risk factors.
Area of Science:
- Neurology and Public Health
- Geriatric Medicine
- Epidemiology of Cognitive Decline
Background:
- Cardiovascular burden is a known risk factor for cognitive dysfunction and dementia.
- Translating research on cardiovascular risk into primary care for cognitive health remains a challenge.
- The Hachinski Ischemic Scale (HIS) is a tool used to assess vascular contributions to cognitive impairment.
Purpose of the Study:
- To evaluate the effectiveness of the Hachinski Ischemic Scale (HIS) in identifying cognitive dysfunction.
- To assess the utility of the HIS in diagnosing mild cognitive impairment (MCI) within an ethnically diverse population.
- To explore potential ethnic variations in the relationship between vascular factors and cognitive impairment.
Main Methods:
- Analysis of data from 517 participants in Project FRONTIER, including 211 Mexican Americans and 306 non-Hispanic Whites.
- Utilized comprehensive neuropsychological measures to assess cognitive functioning across different domains.
- Examined the correlation between HIS scores and cognitive performance, as well as the prediction of MCI diagnosis.
Main Results:
- In non-Hispanic Whites, HIS scores significantly correlated with poorer global cognition, immediate memory, attention, and executive functioning, and predicted MCI diagnosis.
- For Mexican Americans, HIS scores were significantly associated with immediate memory, attention, and executive functioning.
- However, HIS scores did not significantly predict MCI diagnosis in the Mexican American group.
Conclusions:
- HIS scores demonstrated a relationship with cognitive functioning, but this relationship varied significantly by ethnicity.
- Findings suggest that vascular factors may contribute to MCI risk in non-Hispanic Whites but not necessarily in Mexican Americans.
- This underscores the importance of considering ethnic differences in risk factors for mild cognitive impairment.
Objective:
cardiovascular burden is considered a risk factor for the development of cognitive dysfunction and dementia. While this link is well established in the literature, implementing this work in primary care settings remains a challenge. The goal of this study is to examine the utility of the Hachinski Ischemic Scale (HIS) in identifying cognitive dysfunction and diagnosis of mild cognitive impairment (MCI) in an ethnically diverse sample.
Methods:
data were analysed on 517 participants (211 Mexican Americans and 306 non-Hispanic Whites) recruited from Project FRONTIER, a study of rural health. Neuropsychological measures were utilised to assess for cognitive functioning.
Results:
among non-Hispanic Whites, HIS scores were significantly related to poorer performance on tasks of global cognition [B (SE) = -0.13 (0.06), P = 0.02], immediate memory [B (SE) = -0.85 (0.26), P < 0.001], attention [B (SE) = -1.6 (0.36), P < 0.001] and executive functioning [B (SE) = 0.46 (0.12), P < 0.001], and significantly predicted diagnosis of MCI [odds ratio (OR) = 1.4; 95% confidence interval (CI) = 1.2-1.6]. For Mexican Americans, HIS scores were significantly related to immediate memory [B (SE) = -0.78 (0.28), P = 0.01], attention [B (SE) = -0.74 (0.36), P = 0.04] and executive functioning [B (SE) = 0.37 (0.14), P = 0.01]; however, HIS scores were not significantly related to diagnosis of MCI in Mexican Americans (OR = 1.2, 95% CI = 0.96-1.4, P = 0.116).
Conclusion:
HIS scores were related to cognitive functioning; however, these results differed by ethnicity. It is possible that these findings indicate that vascular factors may increase risk for MCI among non-Hispanic Whites but not for Mexican Americans. These findings are consistent with past research that suggests risk factors for MCI may differ by ethnicity.
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