Holistic Approaches to Hispanic Health

Exploring cultural and cardiovascular links to dementia in Latino Americans

By Peggy Pico

Taking better care of one’s heart can protect against Alzheimer’s disease and other forms of dementia.

But, new evidence suggests that Latino Americans are at an increased risk of developing Alzheimer’s and tend to display symptoms at a younger age than non-Latino populations in the U.S.

“Having high blood pressure and obesity, or other cardiovascular- related illnesses, seems to accelerate cognitive decline among Latinos more than in non-Latino whites, and we want to know why,” said Ariana Stickel, Ph.D., assistant professor of psychology at San Diego State University.

Cognitive decline is a condition that leads to memory loss, reduced or slower thinking and impaired mental capabilities. It often begins slowly, when forgetting a familiar route home or having difficulty understanding a simple conversation. It frequently progresses to the inability to recognize family, friends and even one’s own reflection.

Alzheimer’s disease is an irreversible deterioration of the brain. It results in severe cognitive decline, personality changes, the inability to perform basic daily activities and ultimately death.

There is no cure. But identifying and understanding the biological, cultural and socioeconomic risks for specific groups, including Latinos, is critical for prevention, early diagnosis and the development of treatments, said Stickel.

“One piece missing from the existing research is that Latinos often go longer periods of time with undiagnosed and untreated cardiovascular-related illnesses than other ethnic and racial groups,” she said.

According to the National Institutes of Health (NIH), the disproportionate incidence of cardiovascular illness and Alzheimer’s disease among Latinos may be linked to biological and cultural factors including acculturation.

Acculturation is when an individual, family or group adopts, replaces or modifies their customs, values, dietary habits and other behaviors to another (typically) dominant cultural norm.

Several NIH studies are underway to determine acculturation’s effect on health and health disparity in minority populations. Stickel’s research project is among them.

“My research explores the relationships between cardiovascular disease risk factors, brain structure and small vessel disease, and cognition, while also investigating external influences, including acculturation and health disparities among Latinos living in the U.S.”

Diversity and scope

Stickel’s study is part of two massive research projects on cognitive aging and cognitive impairment among diverse Latino populations in the country.

The Hispanic Community Health Study/Study of Latinos collected data on heart and lung diseases from more than 16,000 participants from San Diego, New York, Chicago and Miami. Participants had heritage from Cuba, Central and South America, the Dominican Republic, Mexico and Puerto Rico. More than half of the participants, aged 45 years and older, also underwent cognitive testing.

Among the study’s principal investigators are SDSU’s Linda Gallo, Ph.D., professor of psychology, and Gregory Talavera, M.D., distinguished professor in the Graduate School of Public Health, who serve as co-directors at the SDSU South Bay Latino Research Center.

The Study of Latinos-Investigation of Neurocognitive Aging looked at cardiovascular and genetic risk factors for cognitive change and mild cognitive impairment as a precursor of Alzheimer’s disease in more than 6,000 participants. Its follow-up study, SOL-INCA 2, is underway and examines the original participants to identify which risk factors lead to Alzheimer’s disease or other forms of dementia.

Risks and prevention

Stickel’s current work contributes to and expands on both studies.

“Specifically, I investigate lifestyle, migration history and acculturative factors, health disparities and socioeconomic issues that may lead to biological risk for dementia,” she said.

Multiple long-term studies have found evidence that people who make healthy lifestyle changes, such as controlling high blood pressure and excessive weight gain, and doing heart-health exercise, may reduce the risk of getting Alzheimer’s or other dementias.

“So, there is something you can do right now that may reduce your risk of cognitive decline. That is preventing or managing cardiovascular risk through exercise, diet or medications to help your brain in the long term,” Stickel said.

She explained that her ultimate goal is to find ways to prevent cognitive decline from Alzheimer’s disease and related dementias.

“Our research is meant to inform public health care among Latinos and all aging adults,” she said. “We want to prevent dementia or slow its development, and for those already facing dementia, we want to pinpoint treatment interventions to improve their quality of life.

“The long-term solution to addressing cognitive impairment and dementia must include population-specific research and strategies that recognize biological, ethnic and racial lifestyle differences.”