Impact of Racial Differences in Alzheimer Biomarkers


Cerebral impairment in older African Americans is related with smaller changes in cerebrospinal fluid (CSF) tau biomarkers but greater influence from white matter hyperintensity (WMH) burden compared with impairment in older white Americans, according to a study from Emory University in Atlanta, Georgia.

These race-associated variance in CSF tau markers may result in underdiagnosis of Alzheimer disease(AD) in African Americans, according to the researchers. This is the primary research to directly look at race, CSF AD biomarker levels, and the relationships between WMH and cognition.      

Background

The research team noted that the occurrence of AD is nearly doubled in African Americans compared with whites. Although African Americans also reportedly are more likely than whites to have nonamnestic forms of mild cognitive impairment (MCI) and slower decay to and through dementia, postmortem studies show that they have greater ischemia, which is related with WMH burden, and Lewy body copathology.                                                         

Study design

The Emory team assumed that CSF amyloid biomarkers, dysfunction and neurodegeneration would differ between older black and white Americans with normal understanding and AD-associated cerebral impairment. They prospectively involved older black and white Americans with either normal thought, MCI, or AD to explore race-related alterations in efforts to improve the classification of AD and non-AD pathology in older African Americans. A total of 66 older black and 72 older white Americans (average age, 70 years for both cohorts) were registered in the study and underwent detailed clinical, neuropsychological, MRI, genetic, and CSF analyses. Aβ40 and Aβ42, tau, neurodegenerative and candidate endothelial markers, and soluble intercellular cell adhesion molecule 1 were characterized to test their association with cerebral impairment within each race.


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