Ariana M. Stickel

Background: Hispanic/Latino adults are not a monolithic group. Individuals vary in a range of factors, including levels of acculturation (adoption of Anglo-American culture). Objective: To investigate the relationships between acculturation with cognition, changes in cognition, and risk for mild cognitive impairment (MCI). Methods: We included Hispanic/Latino adults (unweighted n = 5976) from the Study of Latinos - Investigation of Neurocognitive Aging (SOL-INCA), a Hispanic Community Health Study/Study of Latinos ancillary study. Three acculturation measures were collected at Visit 1 (Short Acculturation Scale for Hispanics (SASH) – Social and Language subscales and the MESA Acculturation score). Participants were grouped into quartiles per measure with higher scores reflecting greater acculturation. Outcomes included cognition and MCI prevalence 7-years after Visit 1 and 7-year change in cognition from Visit 1 to 2. Survey linear regressions were performed to model the associations between acculturation measures and cognitive outcomes, controlling for sociodemographic factors. Results: The lowest SASH Social and Language acculturation groups had lower global cognition scores than all other groups (all p -valuesb = 0.10; SE = 0.04; p < 0.05). However, there were no acculturation differences in cognitive change or MCI. Conclusions: Though low acculturation was associated with lower cognitive performance, it does not seem to be related to increased risk for cognitive decline or pathological cognitive aging (i.e., prevalent MCI).

Background and ObjectivesHispanic/Latino Americans are disproportionately affected by vascular risk factors (VRFs) linked to cognitive decline, yet they remain underrepresented in neuroimaging rese...

Background and ObjectivesHigh adherence to the Mediterranean diet (MeDi) has been associated with slower age-dependent cognitive decline and better cardiovascular health (CVH). We examined the asso...

Low life-course socioeconomic position (SEP) has been associated with worse cognitive function in older age. However, its association with brain structure remains unclear. We assessed whether SEP at 3 periods of the life-course and socioeconomic mobility are associated with later-life MRI-derived brain volumes. We used longitudinal data from the Hispanic Community Health Study/Study of Latinos and its Investigations of Neurocognitive Aging-MRI ancillary study. We determined childhood SEP using participant self-reports of their parent's educational attainment (z-scored brain volumes. We included 2,400 adults aged 50-85 years. Higher childhood SEP (TGMV 0.13; 95% CI 0.02-0.24) and higher height residuals (TGMV 0.17; 95% CI 0.09-0.24) were associated with larger brain volumes. Similarly, higher adult SEP at visit 1 (TGMV 0.18; 95% CI 0.05-0.31) and visit 2 (TGMV 0.16; 95% CI 0.04-0.29), upward socioeconomic mobility, and stable high SEP were associated with larger brain volumes. Higher adult SEP at visit 2 (log-WMHV -0.16; 95% CI -0.29 to -0.02) and upward mobility were also associated with smaller log-WMHV. This study highlights the contribution of higher life-course SEP to greater brain health as indexed by larger brain volumes in later life. Our results suggest that the effect of early-life socioeconomic disadvantages persists beyond socioeconomic conditions in adulthood.

Cerebral white matter hyperintensities (WMHs) on MRI are part of the spectrum of age-related brain vascular injury and are associated with increased risk of stroke and dementia. Genome-wide association studies (GWASs) conducted mostly in populations of European ancestry have identified several genetic loci. Although Hispanic/Latino adults have a greater burden of WMHs than their non-Hispanic White counterparts, they are vastly underrepresented in genetic studies. We sought to characterize the genetic architecture of WMHs in a Hispanic/Latino cohort by investigating the transferability of known WMH genetic loci and by leveraging Hispanic/Latino genetic diversity to map novel loci. We conducted genome-wide association and admixture mapping analyses of WMH volume in a sample of 2,159 diverse Hispanic/Latino adults (mean age: 62.4 years; 66% female). We investigated associations at 27 previously identified WMH loci. To identify additional loci, we meta-analyzed our genome-wide association results with those of the largest GWASs published to date. Accounting for population differences in linkage disequilibrium, we found some evidence of transferability of 20 of the 27 known WMH loci. Owing to power limitations, we could not exclude transferability of the remaining loci. Multiancestry meta-analysis combining our Hispanic/Latino genome-wide association results with those from a GWAS of non-Hispanic White (NHW) and African American (AA) populations identified a novel locus on 12q22 (p = 1.8 × 10⁻⁸) near NTN4 and tagged by rs10859915, which was previously associated with blood pressure and is an expression quantitative trait locus of AMDHD1. Admixture mapping identified a novel locus on 14q13.2, where higher counts of European ancestry at that locus were significantly associated with higher WMH volume (p = 4.9 x 10⁻⁷). This locus spans an 800-kilobase region containing RALGAPA1, with known impact on neuronal function and brain development. Aggregated rare coding variants in this gene were associated with WMHs in a previous analysis of 20,719 stroke-free and dementia-free adults. Our study suggests that WMH loci previously identified in NHW and AA individuals are relevant to Hispanic/Latino adults. It demonstrates the power of the diverse Hispanic/Latino population to fine-map known genetic loci and discover novel ones, augmenting our understanding of the genetic architecture of cerebral WMHs.

Purpose: This study aimed to identify individual factors associated with older adults' ability to manage commercially available over-the-counter (OTC) hearing aids (HAs). Method: Participants completed an OTC HA skills assessment, scored on a 4-point Likert scale (3 = independent with no difficulty , 0 = unable to complete ). Steps included downloading the application (app), inserting the HAs, and cleaning them with a brush. Scores were averaged to calculate an overall mean; higher scores indicated better OTC HA skills. Each independent variable was analyzed in separate linear regression models, and geometric mean ratios (GMRs) were calculated for significant factors. OTC HA skills were also examined dichotomously, with unsuccessful performance defined as any unresolved error. Results: Eighty-two adults participated in the study, 66% ( n = 54) of whom were new HA users. After adjusting for covariates, education remained a strong predictor of OTC HA skills: Individuals with less than a college degree demonstrated 45% lower performance compared to those with a master's degree or higher (GMR = 0.55, 95% confidence interval [0.34, 0.89]). Overall, 68% ( n = 56) of participants were unsuccessful in completing the OTC HA assessment. The most challenging tasks across all participants were manually adjusting the volume, pairing the HAs with a smartphone, and replacing the wax guard. New HA users performed significantly worse than experienced users on the task of putting the HAs on, t (52) = −2.58, p = .013, with a moderate effect size (Cohen's d = −0.44). Conclusions: Education emerged as a strong predictor of OTC HA skills, underscoring the need to address disparities in device usability. These findings highlight the importance of developing tailored devices and educational materials to support users with lower educational attainment. Such efforts may help promote more equitable access and prevent the exacerbation of existing hearing health disparities in the era of OTC HAs. Supplemental Material: https://doi.org/10.23641/asha.29847827

Better cardiovascular health (CVH), measured using the Life's Simple 7 (LS7) score, is associated with improved cognitive function. However, its effect on brain imaging in Hispanics/Latinos has not been reported. We investigated the association of LS7 score with brain MRI outcomes in a diverse Hispanic/Latino population. Hispanic Community Health Study/Study of Latinos (HCHS/SOL) is the largest prospective cohort study of diverse Hispanic/Latino adults in the United States. LS7 score was assessed at baseline (2008–2011). The SOL-Investigation of Neurocognitive Aging (SOL-INCA) MRI ancillary study recruited HCHS/SOL participants who underwent neuroimaging approximately 10 years (2017–2022) later. Main outcomes include standardized residuals for total brain, total and lobar gray matter (frontal, temporal, parietal, and occipital), total white matter, total CSF, lateral ventricle (LV), and white matter hyperintensity (WMH) volumes and diffusion tensor imaging (mean free water fraction, peak width skeletonized mean diffusivity, and mean fractional anisotropy). MRI outcomes across continuous LS7 scores were investigated using adjusted linear regression models. We performed an interaction analysis by age and sex. All analyses accounted for complex sample design. The study included 2,659 participants (weighted %female = 56%). The mean age (95% CI) was 54 (53–55) years, and the mean LS7 score was 7.2 (7.1–7.3). In the fully adjusted model, higher LS7 scores were associated with larger total and lobar brain volumes (β_{Total Brain} = 0.03 [0.002 to 0.06], β_{Total White} = 0.05 [0.03 to 0.08], β_{Total Gray} = 0.04 [0.01 to 0.06], β_{Frontal Gray} = 0.04 [0.02 to 0.07]); smaller total CSF (β = −0.06 [-0.08 to −0.03]), LV (β = −0.03 [-0.06 to −0.004]), and WMH (β = −0.05 [-0.07 to −0.03]) volumes; and better measures of microstructural integrity (β_FW = −0.002 [-0.003 to −0.001], β_PSMD = −0.01 [-0.01 to −0.003], and β_FA = 0.001 [0.001 to 0.002]). In interaction analysis by age, the benefits of CVH on magnetic resonance volumes and microstructural integrity were more pronounced in older patients. No interaction was observed by sex. We found that better CVH is associated with better brain-based volumes and microstructural integrity and that the effects of LS7 score on brain health are age dependent. Additional studies are needed to assess the longitudinal effect of CVH on MR-based brain health outcomes.

Sleep disordered breathing (SDB) is a risk factor of stroke and Alzheimer disease and related dementias (ADRDs). Hispanic/Latino adults have higher risk of SDB and ADRDs, which emphasizes the need to better understand the association between SDB and brain health. Furthermore, results on SDB and brain aging are mixed, and there are limited data for Hispanic/Latino adults. The main goal of this study is to assess the association between SDB and brain MRI measures in a diverse Hispanic/Latino population. The Hispanic Community Health Study/Study of Latinos (HCHS/SOL) is a community-based prospective cohort multisite (Bronx, Chicago, Miami, San Diego) study of diverse Hispanic/Latino adults in the United States. Participants underwent 1 night of unsupervised home testing with a sleep apnea test device at baseline. The SOL-Investigation of Neurocognitive Aging MRI, an ancillary study, recruited 2,667 HCHS/SOL participants (35-85 years) who underwent neuroimaging approximately 10 years after baseline sleep assessment. The main exposure was the respiratory event index (REI, 3% desaturation). Secondary exposures encompassed measures of oxygen saturation. Main outcomes included total brain, gray matter, white matter hyperintensity (WMH), and hippocampal volumes. Survey linear regression models were used to determine associations between SDB and brain MRI measures. The mean age was 67.6 years, with a body mass index of 29.7, and 58.3% were female. We found that increased REI was associated with larger hippocampal volumes (b_hippocampus = 0.006 [0.001-0.012]). These results were consistent with oxygen levels (minimum SpO₂%) during sleep (b_hippocampus = -0.013 [-0.021 to -0.004]). Lower oxygen levels (mean SpO₂) during sleep were associated with enlarged WMH volumes (b_WMH = -0.095 [-0.164 to -0.025]). We found that SDB and worse oxygenation during sleep were linked to larger hippocampal volumes. These results underscore the complex relationships between sleep health and brain aging and warrant longitudinal follow-up, starting in middle age or earlier.