Memory improvement in African Americans with amnestic mild cognitive impairment

Abstract

Objective Amnestic mild cognitive impairment (aMCI) has an uncertain course. Valid methods to evaluate memory change will best identify predictors of course. This issue is especially relevant to older persons in minority groups, who may have encountered life course factors that adversely affect cognition. Methods/Design Growth curve mixture models were used to identify trajectories of memory test scores obtained every 6 months over 2 years in 221 African Americans with aMCI. Results Participants sorted into two classes, with clinically and statistically significant differences in memory scores over time. Class 1 (n = 28 [14.7%]) had sustained improved scores. Class 2 (n = 162 [85.3%]) scores remained low, fluctuated, or declined. Class 1 had better baseline cognition and daily function than class 2. Conclusions The observed rate of improved memory is lower than reported reversion rates from aMCI to normal cognition. Evaluating trajectories of memory test scores rather than changes in categorical diagnoses of aMCI, which may depend on recalling (or not recalling) one or two words, may yield a more valid indicator of cognitive change. These approaches require further study in minority groups.

Developing an integrated cognitive behavioral therapy and motivational interviewing intervention for African Americans with mild cognitive impairment: A pilot study.

“…Increased rates of MCI, dementia, and AD in African American communities may be influenced by race-based stressors (e.g., discrimination, microaggression), unhealthy behaviors (e.g., smoking, substance use, physical inactivity, poor nutrition), socioeconomic status, and barriers to quality health care resources (e.g., inadequate cognitive testing and medication; Rovner et al, 2019; Thacker et al, 2014). Relatedly, when African Americans do attempt to seek services, they often face discrimination in healthcare settings (Lee et al, 2012).…”