%A Beydoun, May A. 
%A Beydoun, Hind A. 
%A Fanelli-Kuczmarski, Marie T. 
%A Weiss, Jordan 
%A Georgescu, Michael F. 
%A Meirelles, Osorio 
%A Lyall, Donald M. 
%A Evans, Michele K. 
%A Zonderman, Alan B. 
%D 2023
%T Pathways explaining racial/ethnic and socio-economic disparities in dementia incidence: the UK Biobank study
%! Pathways explaining racial/ethnic and socio-economic disparities in dementia incidence: the UK Biobank study
%K dementia, Alzheimer’s disease, health disparities, socio-economic status, structural equations modeling
%X Background: Pathways explaining racial/ethnic disparities in dementia risk are under-evaluated. Methods: We examine those disparities and their related pathways among UK Biobank study respondents (50–74 y, N = 323,483; 3.6% non-White minorities) using a series of Cox proportional hazards and generalized structural equations models (GSEM).
Results: After ≤15 years, 5,491 all-cause dementia cases were diagnosed. Racial minority status (RACE_ETHN, Non-White vs. White) increased dementia risk by 24% (HR = 1.24, 95% CI: 1.07–1.45, P = 0.005), an association attenuated by socio-economic status (SES), (HR = 1.12, 95% CI: 0.96–1.31). Total race-dementia effect was mediated through both SES and Life’s Essential 8 lifestyle sub-score (LE8LIFESTYLE), combining diet, smoking, physical activity, and sleep factors. SES was inversely related to dementia risk (HR = 0.69, 95% CI: 0.67, 0.72, P < 0.001). Pathways explaining excess dementia risk among racial minorities included ‘RACE_ETHN(−) → SES(−) → DEMENTIA’, ‘RACE_ETHN(−) → SES(−) → Poor cognitive performance, COGN(+) → DEMENTIA’ and ‘RACE_ETHN(−) → SES(+) → LE8LIFESTYLE(−) → DEMENTIA’.
Conclusions: Pending future interventions, lifestyle factors including diet, smoking, physical activity, and sleep are crucial for reducing racial and socio-economic disparities in dementia.

%U https://doi.org/10.18632/aging.205058
%J Aging
%0 Journal Article
%V 15
%N 18
%P 9310-9340
%R 10.18632/aging.205058
%@ 1945-4589