Ethnicity or location? Differential clinical profile of Alzheimer's disease among Puerto Ricans
Camacho Mercado, Clara L.
González Vargas, Carlos I. (Consejero)
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The development of a profile of Puerto Ricans with Alzheimer’s disease (AD) patients was produced considering patients living in areas of high or low mortality rate associated with AD in Puerto Rico (PR). We compared the two groups considering the age at initial evaluation, Mini-Mental State Examination (MMSE) score, co-morbidities and demographic characteristics among these two different areas and contrast them to previous studies conducted at Research Centers in the mainland United States of America (USA). This was a retrospective study using clinical records gathered from two different locations in Puerto Rico. The clinical records used for the research were from subjects diagnosed with probable or possible AD and, at least, one MMSE score of 26 or lower. A total of 491 records were used for this study. The analyzed records were clustered in two groups based on pre-determined low (Metropolitan San Juan Region) and high (Northeast and Northwest Region) mortality rate associated with AD in Puerto Rico. Variables such as demographics, age at initial evaluation, MMSE scores, cognitive skills rate of change and co-morbidities among the groups were compare among these two clusters. The care provider of AD patients per region was also analyzed. Significant difference in the age at initial evaluation and years of education were found between these two groups, where the region with highest mortality rate showed a younger age at the initial evaluation and less years of education than the region with lower mortality rate associated with AD. Both regions showed comparable levels of initial and last MMSE scores and rate of change, but there was significant difference in the profile of co-morbidities. There was also significant difference in the care provider among these two regions. The profile of AD patients in the Hispanic population in Puerto Rico is more similar to what has been reported about white-Caucasians in the US than the Caribbean Hispanic population in Philadelphia and Manhattan. The results suggest that ethnicity is a confounding factor and not a risk factor of AD. Attention should be placed in socioeconomic factors and healthy living practices that are inherent of the different ethnic groups in the US population.