Differences In Biological Risk Factors Research Articles

Diversity and Disparity in Dementia

Debate exists regarding differences in the prevalence of Alzheimer disease (AD) in African Americans and Hispanics in the United States, with some evidence suggesting that the prevalence of AD may be considerably higher in these groups than in non-Hispanic whites. Despite this possible disparity, patients of minority ethnoracial groups often receive delayed diagnosis or inadequate treatment for dementia. This review investigates these disparities by conceptualizing the dementia disease process as a product of both biological and cultural factors. Ethnoracial differences in biological risk factors, such as genetics and cardiovascular disease, may help to explain disparities in the incidence and prevalence of AD, whereas race-specific cultural factors may impact diagnosis and treatment. Cultural factors include differences in perceptions about what is normal aging and what is not, lack of adequate access to medical care, and issues of trust between minority groups and the medical establishment. The diagnosis of AD in diverse populations may also be complicated by racial biases inherent in cognitive screening tools widely used by clinicians, but controlling for literacy level or using savings scores in psychometric analyses has the potential to mitigate these biases. We also suggest that emerging biomarker-based diagnostic tools may be useful in further characterizing diverse populations with AD. Recognizing the gap in communication that exists between minority communities and the medical research community, we propose that education and outreach are a critical next step in the effort to understand AD as it relates to diverse populations.

Psychosocial factors related to cardiovascular disease risk in UK South Asian men: A preliminary study

To compare the exposure to psychosocial factors associated with cardiovascular risk in UK South Asian and white European men. Interview study of 63 healthy UK South Asian and 42 white European men aged 35-75 years, randomly selected from a larger study group in West London. Interviews were administered in Punjabi and English. Measures of psychosocial and cardiovascular risk factors were obtained. Ealing Hospital, West London. The South Asian men had lived in the UK for an average of 27.9 (SD 11.6) years, and had higher educational attainment than the white Europeans. Compared with the white Europeans, the South Asian men lived in significantly more crowded homes, experienced lower job control, greater financial strain, lower neighbourhood social cohesion and more racial harassment. They received less emotional support, and were more depressed and less optimistic on standard questionnaires. These men also had higher waist/hip ratios and were more sedentary, but there were no significant ethnic differences in biological risk factors. South Asian men living in London showed a higher risk profile in psychosocial factors thought to contribute to cardiovascular disease risk. This preliminary investigation is consistent with the possibility that psychosocial adversity contributes to increased vulnerability to coronary heart disease in South Asians resident in the UK.

Socioeconomic differences in dietary patterns among middle-aged men and women

The aim of the study is to (i) identify common dietary patterns, (ii) study socioeconomic differences in these dietary patterns, and (iii) assess whether they contribute to socioeconomic differences in biological risk factors. The data come from the Whitehall II study of London civil servants, who participated in the third phase (1991–1993) and were 39–63-years old ( N=8004). Food frequency questionnaire and socioeconomic background information was from a questionnaire, and biological risk factors from a medical screening. Six dietary patterns were identified. In reference to high employment grade men, the odds ratios of low grade men consuming the ‘unhealthy’ or the ‘very unhealthy’ diet were 1.26 and 3.34, respectively, while the odds for the ‘French’ diet was 0.13. Among women the corresponding odds were 2.98, 6.19 and 0.25. Adjusting for spouse's socioeconomic status and to a lesser extent smoking and exercise as well as job control attenuate these grade differences somewhat. Among men and women adjusting for dietary patterns accounted for about 25—50 per cent of grade differences in HDL and serum triglyceride levels.

Socio-economic position and coronary heart disease risk factors in youth. Findings from the Young Hearts Project in Northern Ireland.

This study investigates the existence of socioeconomic differentials in behavioural and biological risk factors for coronary heart disease in young people from Northern Ireland, taking into account differences in biological maturation. A school-based prospective study, with measurements in 1989/1990 and 1992/1993. Socio-economic position was based on occupational level of the main family breadwinner. Behavioural risk factors included were physical inactivity, the intake of total energy, dietary fat and a number of micronutrients. Biological risk factors included were blood pressure, body fatness, lipoproteins and cardio-pulmonary fitness. Biological maturation was based on Tanner's stages. 251 boys and 258 girls who were measured at the age of 12 years and re-examined at the age of 15 years. Cross-sectional analyses showed that socio-economic differences in cholesterol intake (in boys) and physical inactivity and total energy intake (in girls) were present at 12 and 15 years of age, while differences in fat and fruit intake and smoking behaviour (in boys and girls) became established at the age of 15 years, with unfavourable levels in subjects in the manual group. Longitudinal analyses confirmed that differences in behavioural risk factors exist or develop during adolescence. No clear pattern of differences in biological risk factors was found by socio-economic position. Adjustment for biological maturation did not materially alter the results. Differences in lifestyle by socio-economic position seem to become established in adolescence. These differences however, are not (yet) reflected in differences in biological risk factors by socio-economic position.

Behavioural counselling in general practice for the promotion of healthy behaviour among adults at increased risk of coronary heart disease: randomised trial.

Objective: To measure the effect of behaviourally oriented counselling in general practice on healthy behaviour and biological risk factors in patients at increased risk of coronary heart disease.Design: Cluster randomised...

Differences in biological risk factors for cardiovascular disease between three ethnic groups in the Whitehall II study

This study compares risk factors for cardiovascular disease in civil servants of three ethnic groups screened as part of the Whitehall II cohort study. Previously identified risk factors for cardiovascular disease in 360 Afro–Caribbean and 577 South Asian subjects are compared with the 8973 white Caucasian subjects. Controlling for socio-economic status is more precise than in most previous studies of cardiovascular differences between ethnic groups. After controlling for socio-economic confounding factors, age and sex, South Asian subjects were found to have increased prevalence of hypertension (defined as either having systolic pressure of >160, diastolic pressure of >95 or being on antihypertensisves) OR 2.3 (95% CI 1.6–3.3), diabetes OR 4.2 (95% CI 3.0–5.8) and a high risk lipid profile, although total cholesterol was lower than in the white population. Afro–Caribbean subjects had more hypertension OR 4.0 (95% CI 2.8–5.7) and diabetes OR 2.8 (95% CI 1.7–4.6), but this was accompanied by a favourable lipid profile with low cholesterol and high HDL. Afro–Caribbean alcohol and smoking habits were low-risk. Socio-economic status was found to be an important confounding factor for ethnic differences in biochemical risk factors for cardiovascular disease. However, adjusting for socioeconomic class only attenuates observed differences; it does not abolish them.