Neuroimaging markers of dementia across race/ethnicity and sex/gender using an intersectional approach within the HABS-HD cohort.

INTRODUCTION

Racial/ethnic and sex/gender differences in neuroimaging markers of dementia have been previously explored, but rarely with an intersectional approach.

METHODS

Using data from the Health and Aging Brain Study-Health Disparities cohort, we examined neuroimaging markers of dementia using both interaction between race/ethnicity and sex/gender and effect modification of race/ethnicity by sex/gender.

RESULTS

We analyzed data from 3433 dementia-free participants with either magnetic resonance imaging or positron emission tomography (PET) data at baseline (mean [standard deviation] age: 65 [9] years, 36% non-Hispanic White [NHW], 27% Black, 37% Hispanic, and 63% women). Compared to NHW, Black men had lower global amyloid PET standardized uptake value ratio (SUVR; β [95% confidence interval]: -0.32 [-0.53, -0.11]), and Hispanic (0.65 [0.39, 0.91]) and Black women had greater medial temporal lobe tau SUVR (0.49 [0.30, 0.69]).

DISCUSSION: We observed that the distribution of neuroimaging markers of dementia differed across racial/ethnicity groups by sex/gender. An intersectional approach can aid in tailoring research and clinical efforts in preventing and treating dementia.

HIGHLIGHTS: Hispanic and Black women had greater medial temporal lobe tau deposition, compared to their non-Hispanic White counterparts. Black men had lower global amyloid deposition compared to non-Hispanic White men. Black men and women had higher burden of cerebral small vessel disease compared to their non-Hispanic White counterparts, with stronger associations in Black men.