Assessing Alzheimer's Disease Risk Among Latina/o/x Older Adults: A CART Analysis

Alzheimer's Disease (AD) presents a significant public health challenge in the U.S., with Latina/o/x elders being disproportionately affected. This study examines the key risk factors associated with AD in this population.

We analyzed data from the National Alzheimer's Coordinating Center (2017), focusing on 9,801 Latina/o/x older adults (32.7% males and 67.3% females). Statistical analyses conducted included Chi-square tests, t-tests, and Classification and Regression Tree (CART) analysis, which was used as the main statistical tool.

The CART model, trained on 70% of the sample and tested on the remaining 30% (N = 9,801), identified seven terminal nodes and selected seven key predictors from 16 candidate variables. The model demonstrated modest discriminative ability (AUC = 0.68 for both training and test sets; misclassification error ≈ 36%). Sensitivity was 75%, while specificity was 55% in the test set. The most important predictors included age, education, smoking history, BMI, hypertension, and use of antidepressant or antipsychotic medications. A critical threshold emerged at < 5.5 years of education, which, in interaction with age and smoking, was associated with notably increased AD risk.

This study emphasizes the crucial role of sociodemographic factors-particularly gender, age, and education-in determining AD risk among Latina/o/x elders. CART analysis identified key thresholds for age and education levels impacting AD risk. The findings suggest the need for targeted interventions and policies, with a focus on education and lifestyle factors, to mitigate AD risk in this vulnerable population.