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Abstract
Association of Lifetime Discrimination with Cerebral Small Vessel Disease and Amyloid PET: the Multi‐Ethnic Study of Atherosclerosis (MESA)
Alzheimer's & dementia, v 21
Dec 2025
Abstract
Background Discrimination impacts various health‐related outcomes and may explain the excess risk for Alzheimer’s disease (AD) and related dementias in minoritized groups through associations with vascular and AD biomarkers related to cognitive function. We hypothesize relationships between discrimation and imaging biomarkers will be observed in minoritized groups. Method We used data from MESA, a prospective cohort study that enrolled 6,814 participants at baseline (2000‐02). Exposures were experience of racial discrimination, and number of reasons for discrimination (1 or 2+ reasons) at baseline. During exam periods in 2016‐18 and 2019‐21, brain imaging with 3‐Tesla MRI (n = 1372) and amyloid PET (n = 422) were completed. The primary outcomes were (1) measures of cerebral small vessel disease including white matter hyperintensities (log WMH, continous), cerebral microbleeds (CMB, present / absent) and enlarged perivascular spaces in the whole brain (log ePVS, continuous); and (2) amyloid PET positivity (Centiloids ≥ 12.2). Multivariable linear (WMH and ePVS) and logistic (CMB and amyloid PET positivity) regression models were adjusted for covariates including age, sex, site, education, and inverse probability weight. WMH and ePVS models were also adjusted for intracranial volume. All models were stratified by ethnoracial group. Result Participants were 72.3 (7.8) years of age on average at MRI and were 42% White, 11% Chinese, 26% Black, and 21% Hispanic. Black and Hispanic participants were more likely than other groups to report experiencing racial discrimination and a higher burden (2+ reasons) of discrimination. Racial discrimination was significantly associated with smaller ePVS volumes in White participants, and larger ePVS volumes in Black participants, endorsing 2+ reasons for discrimination was associated with larger ePVS volumes in Hispanic participants. Reporting one reason for discrimination was associated with higher volume of WMH in Black and Hispanic particpants (Table 1). Lifetime discrimination was associated with higher odds of CMB in Hispanic participants (Figure 1). Endorsing 2+ reasons was significantly associated with higher burden of cerebral amyloid among Black participants (Figure 2). Conclusion Experiences of lifetime racial discrimination and burden of various forms of lifetime discrimination are associated with imaging biomarkers implicated in cognitive function. Associations are more pronounced within different ethnoracial groups.
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Details
- Title
- Association of Lifetime Discrimination with Cerebral Small Vessel Disease and Amyloid PET: the Multi‐Ethnic Study of Atherosclerosis (MESA)
- Creators
- Sarah N Forrester - University of Massachusetts Chan Medical SchoolJordan E. Tanley - Wake Forest UniversityMichael P. Bancks - Wake Forest UniversityChinedu T Udeh-Momoh - Wake Forest UniversitySusan R. Heckbert - University of WashingtonMohamad Habes - The University of Texas Health Science Center at San AntonioStephen R. Rapp - Wake Forest UniversityBonnie C. Sachs - Wake Forest UniversityIlya M. Nasrallah - University of PennsylvaniaR. Nick Bryan - University of PennsylvaniaKatya Rascovsky - University of PennsylvaniaClara Li - Icahn School of Medicine at Mount SinaiKathleen M. Hayden - Wake Forest UniversityJosé A Luchsinger - Columbia University Irving Medical CenterMarcia Pescador Jimenez - Boston UniversityLilah M Besser - University of MiamiJana A. Hirsch - Drexel UniversityWendy Post - Johns Hopkins UniversitySudarshan Krishnamurthy - Wake Forest UniversityTimothy M. Hughes - Wake Forest University
- Publication Details
- Alzheimer's & dementia, v 21
- Number of pages
- 3
- Resource Type
- Abstract
- Language
- English
- Academic Unit
- Urban Health Collaborative; Epidemiology and Biostatistics
- Other Identifier
- 991022147202804721