Neuropsychological Deficit Profiles, Vascular Risk Factors, and Neuropathological Findings in Hispanic Older Adults with Autopsy-Confirmed Alzheimer’s Disease

Article type: Research Article

Authors: Weissberger, Gali H.^{a; *} | Gollan, Tamar H.^{b; c} | Bondi, Mark W.^{b; f} | Nation, Daniel A.^g | Hansen, Lawrence A.^{d; e} | Galasko, Douglas^{d; f} | Salmon, David P.^d

Affiliations: [a] Department of Family Medicine, USC Keck School of Medicine, Alhambra, CA, USA | [b] Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA | [c] Department of Psychology, University of California, San Diego, La Jolla, CA, USA | [d] Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA | [e] Department of Neuropathology, University of California, San Diego, La Jolla, CA, USA | [f] Neurology Service, VA San Diego Healthcare System, San Diego, CA, USA | [g] Department of Psychology, University of Southern California, Los Angeles, CA, USA

Correspondence: [*] Correspondence to: Gali Weissberger, PhD, University of Southern California, Department of Family Medicine, 1000 S. Fremont Avenue, Unit 22, HSA Building A-6, 4th Floor, Room 6437A, Alhambra, CA 91803, USA. E-mail: Gali.Weissberger@med.usc.edu.

Abstract:  This study aimed to determine if patterns of neuropsychological deficits, vascular risk factors, and neuropathology differ in Hispanic and Non-Hispanic patients with autopsy-confirmed Alzheimer’s disease (AD). Participants were enrolled in a longitudinal study at the Shiley-Marcos AD Research Center at the University of California, San Diego. Hispanic (n = 14) and Non-Hispanic (n = 20) patients with autopsy-confirmed AD who scored ≥95 on the Dementia Rating Scale (DRS) were included. Patient groups were matched on age, education, global mental status, and severity of functional decline; they were compared to Hispanic (n = 14) or Non-Hispanic (n = 20) cognitively-normal controls of similar age and education. Ethnicity (Hispanic, Non-Hispanic) by disease state (autopsy-confirmed AD or cognitively normal) comparisons were made for cognitive test performance and vascular risk factors. Patient groups were further compared on measures of AD (Braak stage, neuritic plaques, neurofibrillary tangles), vascular neuropathology, and performance across cognitive domains of memory, language, attention, executive functions, and visuospatial abilities after scores were z-transformed based on respective culturally-appropriate control groups. Patient groups had similar overall AD pathology burden, whereas Hispanics with AD had more small parenchymal arteriolar disease and amyloid angiopathy than Non-Hispanics with AD. Despite largely similar pathology, Hispanics with AD were less cognitively impaired (relative to respective NC groups) than Non-Hispanics with AD, and exhibited a different pattern of deficits across cognitive domains. Findings suggest that cognitive deficits that are usually prominent in AD may be less salient in Hispanic patients and this may adversely impact the ability to clinically detect the disease in mild to moderate stages.

Keywords: Alzheimer’s disease, autopsy, bilingualism, Hispanics, neuropsychology

DOI: 10.3233/JAD-180351

Journal: Journal of Alzheimer's Disease, vol. 67, no. 1, pp. 291-302, 2019