Associations of Allostatic Load with Level of and Change in Cognitive Function Among Middle-Aged and Older Hispanic/Latino Adults: The Study of Latinos-Investigation of Neurocognitive Aging (SOL-INCA)

Article type: Research Article

Authors: Estrella, Mayra L.^{a; b; *} | Tarraf, Wassim^c | Kuwayama, Sayaka^d | Gallo, Linda C.^e | Salazar, Christian R.^f | Stickel, Ariana M.^e | Mattei, Josiemer^g | Vásquez, Priscilla M.^h | Eldeirawi, Kamal M.ⁱ | Perreira, Krista M.^j | Penedo, Frank J.^k | Isasi, Carmen R.^l | Cai, Jianwen^m | Zeng, Donglin^m | González, Hector M.ⁿ | Daviglus, Martha L.^b | Lamar, Melissa^{b; o}

Affiliations: [a] Rush Alzheimer’s Disease Center and the Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA | [b] Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL, USA | [c] Institute of Gerontology and Department of Healthcare Sciences, Wayne State University, Detroit, MI, USA | [d] Department of Neurosciences and Shiley-Marcos Alzheimer’s Disease Research Center, University of California, San Diego, San Diego, CA, USA | [e] Department of Psychology, San Diego State University, San Diego, CA, USA | [f] University of California Irvine Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, USA | [g] Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA | [h] Department of Urban Public Health, Charles R. Drew University of Science and Medicine, Los Angeles, CA, USA | [i] Department of Population Health Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL, USA | [j] Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA | [k] Department of Psychology and Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA | [l] Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA | [m] Department of Biostatistics, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC, USA | [n] Department of Neurosciences and Shiley-Marcos Alzheimer’s Disease Research Center, University of California, San Diego, CA, USA | [o] Rush Alzheimer’s Disease Center and the Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA

Correspondence: [*] Correspondence to: Mayra L. Estrella, PhD, MPH, Assistant Professor, Rush Alzheimer’s Disease Center and the Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA. E-mail: mayra_estrella@rush.edu.

Abstract: Background:Higher allostatic load (AL), a multi-system measure of physiological dysregulation considered a proxy for chronic stress exposure, is associated with poorer global cognition (GC) in older non-Hispanic white adults. However, evidence of these associations in middle-aged and older US-based Hispanic/Latino adults is limited. Objective:To examine associations of AL with level of cognition, performance in cognition 7 years later, and change in cognition over 7 years among middle-aged and older US-based Hispanic/Latino adults. Methods:We used data (n = 5,799, 45–74 years at baseline) from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) and SOL-Investigation of Neurocognitive Aging (SOL-INCA). The AL score comprised 16 biomarkers representing cardiometabolic, glucose, cardiopulmonary, parasympathetic, and inflammatory systems (higher scores = greater dysregulation). Cognitive outcomes included GC and individual tests of verbal learning and memory, world fluency (WF), Digit Symbol Substitution (DSS), and Trail Making (Parts A & B). Survey-linear regressions assessed associations of AL with performance in cognition at baseline, 7 years later, and via 7-year cognitive change scores adjusting for sociodemographic characteristics, lifestyle factors, and depressive symptoms. Results:Higher AL was associated with lower baseline performance in GC and WF; and lower 7-year follow-up performance in these same measures plus DSS and Trail Making Parts A & B. Higher AL was associated with more pronounced 7-year change (reduction) in GC and on WF and DSS tests. Conclusions:Findings extend previous evidence in predominantly older non-Hispanic white cohorts to show that AL is related to level of and change in GC (as well as WF and DSS) among middle-aged and older US-based Hispanic/Latino adults.

Keywords: Allostatic load, Alzheimer’s disease, cognitive function, Hispanic/Latino

DOI: 10.3233/JAD-230796

Journal: Journal of Alzheimer's Disease, vol. 99, no. 3, pp. 1047-1064, 2024