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Decomposing Racial and Ethnic Disparities in Risk and Protective Factors of Dementia in the U.S
Nasim B Ferdows1,2, María P Aranda3,4
1Department of Public Health and Health Sciences, Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts, USA.
Clinical Gerontologist
|July 17, 2025
Summary
Racial disparities significantly increase dementia risk. Addressing factors like education, wealth, and health conditions can reduce cognitive decline in older adults, especially minorities.
Area of Science:
- Gerontology
- Public Health
- Neuroscience
Background:
- Racial and ethnic disparities in dementia risk are a significant public health concern.
- Understanding the contributing factors is crucial for developing targeted interventions.
Purpose of the Study:
- To investigate racial/ethnic disparities in dementia risk and protective factors.
- To quantify the contribution of various factors to cognitive differences using the Oaxaca-Blinder method.
Main Methods:
- Retrospective analysis of 3,495 individuals aged 65+ from the Health and Retirement Study (HRS) and Harmonized Cognitive Assessment Protocol (HCAP).
- Cognitive status assessed via Mini-Mental State Examination (MMSE) scores.
- Risk factors (cardiovascular conditions, hearing loss, smoking, depression, inactivity) and protective factors (education, wealth) analyzed.
Main Results:
- Black participants had 2.88 times higher odds of dementia than Whites; Hispanic participants had 1.23 times higher odds (not significant).
- Risk and protective factors explained 32% of the cognitive gap between Black and White participants, and 70% between Hispanic and White participants.
Conclusions:
- Addressing disparities in education, wealth, cardiovascular risks, depression, and hearing loss can reduce cognitive dysfunction.
- Targeting modifiable risk factors and socioeconomic disparities is crucial for improving cognitive health in older adults, particularly minority populations.
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