Objective: To examine differences in prevalence and risk factors of dementia by race/ethnicity and immigrant status using a nationally representative sample of Medicare beneficiaries. Methods: This was a cross-sectional study performed in the United States among non-Hispanic white (NHW), non-Hispanic black (NHB), Hispanic, and other Medicare beneficiaries from round 1 of the National Health and Aging Trends Study (N = 7,609). The authors used log-binomial regression analyses to investigate risk factors and interactions between race/ethnicity and immigrant status and dementia. Stratified log-binomial regression analyses by race/ethnicity were used to interpret the results of interaction effects of immigrant status found in these surveys. Analyses were conducted in three forms: probable dementia versus possible and no dementia, probable and possible dementia versus no dementia; and probable dementia versus no dementia. Results: Consistent with previous studies, U.S.-born NHBs have a higher prevalence of dementia than U.S.-born whites, Hispanics, and others. Immigrant status moderated the relationship between race/ethnicity and dementia. NHWs, Hispanics, and other immigrants had a higher prevalence of dementia compared with their U.S.-born counterparts. However, U.S.-born NHBs had a higher prevalence of dementia compared with NHB immigrants. Results were consistent across the three forms of analysis. Greater age predicted higher dementia across the four racial/ethnic groups. Conclusion: Immigrant status may have complex effects on dementia risk. Selection factors affecting immigration—varied health and educational systems in diverse countries of origin, acculturative stress, and validity of dementia assessment across diverse groups—deserve further attention. © 2018 American Association for Geriatric Psychiatry

Dementia Cognitive disorders prevalence studies risk factors in epidemiology

immigrant Caucasian Dementia race difference immigration human Medicare controlled study Aged United States cross-sectional study Black person Hispanic male female very elderly risk factor Article major clinical study