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Cognitive Correlates of MRI-defined Cerebral Vascular Injury and Atrophy in Elderly American Indians: The Strong Heart Study

Published online by Cambridge University Press:  03 December 2019

Astrid Suchy-Dicey ,
Dean Shibata ,
Brenna Cholerton ,
Lonnie Nelson ,
Darren Calhoun ,
Tauqeer Ali ,
Thomas J. Montine ,
W.T. Longstreth Jr. ,
Dedra Buchwald  and
Steven P. Verney Open the ORCID record for Steven P. Verney [Opens in a new window]
Astrid Suchy-Dicey
Affiliation:
Initiative for Research and Education to Advance Community Health, Washington State University, Seattle, WA, USA Elson S Floyd College of Medicine, Washington State University, Seattle, WA, USA
Dean Shibata
Affiliation:
Department of Radiology, University of Washington, Seattle, WA, USA
Brenna Cholerton
Affiliation:
Department of Pathology, Stanford University, Palo Alto, CA, USA
Lonnie Nelson
Affiliation:
College of Nursing, Washington State University, Seattle, WA, USA
Darren Calhoun
Affiliation:
Phoenix Field Office MedStar Research Institute, Phoenix, AZ, USA
Tauqeer Ali
Affiliation:
Center for American Indian Health Research, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
Thomas J. Montine
Affiliation:
Department of Pathology, Stanford University, Palo Alto, CA, USA
W.T. Longstreth Jr.
Affiliation:
Departments of Neurology and Epidemiology, University of Washington, Seattle, WA, USA
Dedra Buchwald
Affiliation:
Initiative for Research and Education to Advance Community Health, Washington State University, Seattle, WA, USA Elson S Floyd College of Medicine, Washington State University, Seattle, WA, USA
Steven P. Verney*
Affiliation:
Department of Psychology and Psychology Clinical Neuroscience Center, University of New Mexico, Albuquerque, NM, USA
*
*Correspondence and reprint requests to: Steven P. Verney, Department of Psychology and Psychology Clinical Neuroscience Center, University of New Mexico, Psychology MSC03-2220, Albuquerque, NM 87131-0001, USA. E-mail: sverney@unm.edu
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Abstract

Objective:

American Indians experience substantial health disparities relative to the US population, including vascular brain aging. Poorer cognitive test performance has been associated with cranial magnetic resonance imaging findings in aging community populations, but no study has investigated these associations in elderly American Indians.

Methods:

We examined 786 American Indians aged 64 years and older from the Cerebrovascular Disease and its Consequences in American Indians study (2010–2013). Cranial magnetic resonance images were scored for cortical and subcortical infarcts, hemorrhages, severity of white matter disease, sulcal widening, ventricle enlargement, and volumetric estimates for white matter hyperintensities (WMHs), hippocampus, and brain. Participants completed demographic, medical history, and neuropsychological assessments including testing for general cognitive functioning, verbal learning and memory, processing speed, phonemic fluency, and executive function.

Results:

Processing speed was independently associated with the presence of any infarcts, white matter disease, and hippocampal and brain volumes, independent of socioeconomic, language, education, and clinical factors. Other significant associations included general cognitive functioning with hippocampal volume. Nonsignificant, marginal associations included general cognition with WMH and brain volume; verbal memory with hippocampal volume; verbal fluency and executive function with brain volume; and processing speed with ventricle enlargement.

Conclusions:

Brain-cognition associations found in this study of elderly American Indians are similar to those found in other racial/ethnic populations, with processing speed comprising an especially strong correlate of cerebrovascular disease. These findings may assist future efforts to define opportunities for disease prevention, to conduct research on diagnostic and normative standards, and to guide clinical evaluation of this underserved and overburdened population.

Keywords

Neuropsychological testsMagnetic resonance imagingVascular brain injuryCerebrovascular disordersIndiansNorth AmericanHealth status disparitiesCognitive agingCultural diversity
Type
Regular Research
Information
Journal of the International Neuropsychological Society , Volume 26 , Issue 3 , March 2020 , pp. 263 - 275
Copyright
Copyright © INS. Published by Cambridge University Press, 2019

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