Volume 19, Issue 8 p. 3635-3643
RESEARCH ARTICLE

Racial and ethnic differences in neuropsychiatric symptoms and progression to incident cognitive impairment among community-dwelling participants

Ganesh M. Babulal

Corresponding Author

Ganesh M. Babulal

Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA

Department of Psychology, Faculty of Humanities, University of Johannesburg, Johannesburg, South Africa

Department of Clinical Research and Leadership, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA

Institute of Public Health, Washington University in St. Louis, St. Louis, Missouri, USA

Correspondence

Ganesh M. Babulal, Department of Neurology, Washington University School of Medicine, 660 South Euclid Ave., Campus Box 8111, St. Louis, MO 63110, USA.

Email: [email protected]

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Yiqi Zhu

Yiqi Zhu

School of Social Work, Adelphi University, New York, USA

Brown School, Washington University in St. Louis, St. Louis, Missouri, USA

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Jean-Francois Trani

Jean-Francois Trani

Department of Psychology, Faculty of Humanities, University of Johannesburg, Johannesburg, South Africa

Institute of Public Health, Washington University in St. Louis, St. Louis, Missouri, USA

Brown School, Washington University in St. Louis, St. Louis, Missouri, USA

National Center for Arts and Crafts, Paris, France

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First published: 25 February 2023
Citations: 2

Abstract

INTRODUCTION

Neuropsychiatric symptoms (NPS) are a risk factor for dementia; however, their prevalence and severity among ethnoracial groups are poorly understood.

METHODS

We used data from the National Alzheimer's Coordinating Center (NACC) (n = 6958; ≥50 years old). Cognitively normal participants at baseline, without any NPS or dementia diagnosis, had at least one follow-up. Survival analyses assessed the hazard ratio for 12 NPS models and progression to cognitive impairment. Propensity score weighting (PSW) matched participants on age, sex, education, and race/ethnicity.

RESULTS

All 12 NPS were significantly associated with progression to cognitive impairment. In the PSW models, compared to whites, Black/African Americans were more likely to progress to cognitive impairment across all 12 NPS models, followed by Hispanic, and then Asian participants.

DISCUSSION

PSW minimized selection bias to provide robust risk estimates. There is a higher risk of progressing to cognitive impairment for ethnoracial groups with NPS. Tailored screening of NPS and cognitive impairment should incorporate patient and caregiver reports.

CONFLICT OF INTEREST

All authors certify they have no conflicts of interest or disclosures. Author disclosures are available in the supporting information.