INS NYC 2024 Program

Poster	Poster Session 11 Program Schedule 02/17/2024 10:45 am - 12:00 pm Room: Majestic Complex (Posters 61-120) Poster Session 11: Cultural Neuropsychology \| Education/Training \| Professional Practice Issues Final Abstract #110 The Role of Race/Ethnicity and Hypertension Control in Cognitive Performance Daniel Zhang, Cornell University, Ithaca, United States Vanessa Guzman, Columbia University Irving Medical Center, New York, United States Adam Brickman, Columbia University Irving Medical Center, New York, United States Antonio Spagnolo-Allende, Columbia University Irving Medical Center, New York, United States Mitchell Elkind, Columbia University Irving Medical Center, New York, United States Tatjana Rundek, Miller School of Medicine, University of Miami, New York, United States Clinton Wright, National Institute of Neurological Disorders and Stroke (NIH/NINDS), Bethesda, United States Jose Gutierrez, Columbia University Irving Medical Center, New York, United States Category: Aging Keyword 1: hypertension Keyword 2: executive functions Keyword 3: demographic effects on test performance Objective: There is growing evidence that higher blood pressures among non-Hispanic Black adults, compared with non-Hispanic White adults, contribute to racial disparities in cognitive performance. Hypertension is strongly associated with age-related cognitive decline and is a modifiable risk factor for dementia. Non-Hispanic Black and Hispanic adults are disproportionately affected by hypertension and more likely to have poorer blood pressure control throughout the life course. The goal of this study was to determine whether race/ethnicity, hypertension control, and their interaction are associated with cognitive performance in a multiethnic cohort of older adults. Participants and Methods: Participants included 1,112 stroke-free, diverse older adults without dementia from the Northern Manhattan Study. Participants received a neuropsychological evaluation that yielded cognitive domain summary scores that were adjusted for age and education. The primary exposures of interest were self-reported race/ethnicity and hypertension control in relation to memory and executive function domain scores. Hypertension control was classified as: 0) no hypertension, 1) controlled hypertension, 2) poor hypertension control, and 3) untreated hypertension based on blood pressure measurements and anti-hypertensive treatment status obtained at the time of neuropsychological testing. Hypertension was defined as systolic blood pressure > 140 mm Hg, diastolic blood pressure > 90 mm Hg, or use of anti-hypertensive medication. Controlled hypertension was defined as a systolic blood pressure <140 mm Hg and diastolic blood pressure <90 mm Hg. Generalized linear models were used to examine mean differences in memory and executive function domain scores by race/ethnicity, hypertension control, and their interaction adjusting for sex, diabetes, and dyslipidemia. Results: Participants were, on average, 71 years of age and 16% non-Hispanic White, 18% non-Hispanic Black, and 66% Hispanic. Significant differences in hypertension control were observed across racial and ethnic groups χ²(6, 1086) = 14.23, p < .05. Non-Hispanic White participants were less likely to have hypertension and poor hypertension control, while non-Hispanic Black participants had the highest rates of suboptimal hypertension control. Hispanic participants, followed by non-Hispanic Black participants, had lower memory (F(2, 1168) = 29.10, p < 0.01) and executive function (F(2, 1153) = 112.27, p < 0.01) domain scores than non-Hispanic White participants. Memory (F(3, 1096) = 7.96, p < 0.01) and executive function (F(3, 1082) = 15.80, p < 0.01) scores were highest among non-hypertensive participants and lowest among those with poor hypertension control followed by those with untreated hypertension and controlled hypertension, respectively. There was no interaction between race/ethnicity and hypertension control on memory or executive function performance, even after adjusting for sex, diabetes, and dyslipidemia. Conclusions: Cognitive performance varied by race/ethnicity and hypertension control, with non-Hispanic Black participants and participants with suboptimal hypertension score exhibiting the lowest memory and executive function scores. Although non-Hispanic Black and Hispanic participants were more likely to have suboptimal hypertension control than non-Hispanic White participants, hypertension control was not associated with racial disparities in cognitive performance. Adequate blood pressure control is critical for the preservation of brain health and an important goal that may help attenuate observed racial disparities in cognitive impairment and dementia.

Poster

02/17/2024
10:45 am - 12:00 pm
Room: Majestic Complex (Posters 61-120)

Poster Session 11: Cultural Neuropsychology | Education/Training | Professional Practice Issues

Final Abstract #110

The Role of Race/Ethnicity and Hypertension Control in Cognitive Performance

Daniel Zhang, Cornell University, Ithaca, United States
Vanessa Guzman, Columbia University Irving Medical Center, New York, United States
Adam Brickman, Columbia University Irving Medical Center, New York, United States
Antonio Spagnolo-Allende, Columbia University Irving Medical Center, New York, United States
Mitchell Elkind, Columbia University Irving Medical Center, New York, United States
Tatjana Rundek, Miller School of Medicine, University of Miami, New York, United States
Clinton Wright, National Institute of Neurological Disorders and Stroke (NIH/NINDS), Bethesda, United States
Jose Gutierrez, Columbia University Irving Medical Center, New York, United States

Category: Aging

Keyword 1: hypertension
Keyword 2: executive functions
Keyword 3: demographic effects on test performance

Objective:

There is growing evidence that higher blood pressures among non-Hispanic Black adults, compared with non-Hispanic White adults, contribute to racial disparities in cognitive performance. Hypertension is strongly associated with age-related cognitive decline and is a modifiable risk factor for dementia. Non-Hispanic Black and Hispanic adults are disproportionately affected by hypertension and more likely to have poorer blood pressure control throughout the life course. The goal of this study was to determine whether race/ethnicity, hypertension control, and their interaction are associated with cognitive performance in a multiethnic cohort of older adults.

Participants and Methods:

Participants included 1,112 stroke-free, diverse older adults without dementia from the Northern Manhattan Study. Participants received a neuropsychological evaluation that yielded cognitive domain summary scores that were adjusted for age and education. The primary exposures of interest were self-reported race/ethnicity and hypertension control in relation to memory and executive function domain scores. Hypertension control was classified as: 0) no hypertension, 1) controlled hypertension, 2) poor hypertension control, and 3) untreated hypertension based on blood pressure measurements and anti-hypertensive treatment status obtained at the time of neuropsychological testing. Hypertension was defined as systolic blood pressure > 140 mm Hg, diastolic blood pressure > 90 mm Hg, or use of anti-hypertensive medication. Controlled hypertension was defined as a systolic blood pressure <140 mm Hg and diastolic blood pressure <90 mm Hg. Generalized linear models were used to examine mean differences in memory and executive function domain scores by race/ethnicity, hypertension control, and their interaction adjusting for sex, diabetes, and dyslipidemia.

Results:

Participants were, on average, 71 years of age and 16% non-Hispanic White, 18% non-Hispanic Black, and 66% Hispanic. Significant differences in hypertension control were observed across racial and ethnic groups χ²(6, 1086) = 14.23, p < .05. Non-Hispanic White participants were less likely to have hypertension and poor hypertension control, while non-Hispanic Black participants had the highest rates of suboptimal hypertension control. Hispanic participants, followed by non-Hispanic Black participants, had lower memory (F(2, 1168) = 29.10, p < 0.01) and executive function (F(2, 1153) = 112.27, p < 0.01) domain scores than non-Hispanic White participants. Memory (F(3, 1096) = 7.96, p < 0.01) and executive function (F(3, 1082) = 15.80, p < 0.01) scores were highest among non-hypertensive participants and lowest among those with poor hypertension control followed by those with untreated hypertension and controlled hypertension, respectively. There was no interaction between race/ethnicity and hypertension control on memory or executive function performance, even after adjusting for sex, diabetes, and dyslipidemia.

Conclusions:

Cognitive performance varied by race/ethnicity and hypertension control, with non-Hispanic Black participants and participants with suboptimal hypertension score exhibiting the lowest memory and executive function scores. Although non-Hispanic Black and Hispanic participants were more likely to have suboptimal hypertension control than non-Hispanic White participants, hypertension control was not associated with racial disparities in cognitive performance. Adequate blood pressure control is critical for the preservation of brain health and an important goal that may help attenuate observed racial disparities in cognitive impairment and dementia.