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Education and Number of Household Members Negatively Impacts Cognitive Outcomes in Latino Individuals
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In Latino individuals, larger household size negatively affects MoCA scores, while higher education positively impacts cognitive outcomes, per SERVE OC trial data.
Bernadette Boden-Albala, MPH, DrPH
Data from the SERVE OC trial, a 2-arm randomized controlled study performed in Orange County, California, showed that number of household members was negatively associated with cognitive outcomes on the Montreal Cognitive Assessment (MoCA) in Latino individuals whereas years of education had positive long-term impacts. Findings from this analysis will inform next steps in assessing the relationship between household makeup, education, and cognitive outcomes.1
The data, presented at the 2024 Alzheimer’s Association International Conference (AAIC), held July 28-August 1, in Philadelphia, Pennsylvania, included 271 participants who self-identified as Hispanic/Latino and completed the MoCA 8.3 in English or Spanish, at baseline. In efforts to better understand the relationship between household size and education and cognitive outcomes, MoCA scores were adjusted for education, adding 1 point for completing 12 years of education or less. Overall, patients were an average age of 45.85 years (SD, 13.57), with 39.85% 50 years or older.
Led by Bernadette Boden-Albala, MPH, DrPH, dean of UC Irvine's Joe C. Wen School of Population and Public Health, number of household members showed a negative association with MoCA scores (B = –0.40; P <.05) while having more than 8 years of education was positively associated with MoCA scores (B = 3.51; P <.05). Using a multivariable linear regression, age of adult (B = –0.5) and having more than 8 years of education (B = 2.00) were significantly associated with MoCA scores (P <.05).
The cohort was comprised of more women than men (63.84% vs 32.47%), with an average MoCA score of 21.97 of 30 available points (SD, 4.40). The majority of patients (58.30%) had completed up to 8 years of education. At baseline, the mean number of household members was 4.58 and mean Memory Index Score of 10.04 (SD, 3.75). Most patients preferred language was Spanish (78.60%), although a small proportion preferred English (16.61%).
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Overall, the average MoCA scores were 22.69 (SD, 4.27) and 21.16 (SD, 4.63) for participants aged less than or greater than 50 years, respectively. The association between having 8 years of education and MoCA scores was lower among those aged less than 50 (B = 1.02) than in those aged greater than 50 (B = 2.54).
Kurzman et al concluded that "Further research is needed to better understand if the MoCA is an appropriate cognitive assessment to use in minority communities in the US, particularly those with low education, and whether it should be further adjusted to address differences in education attainment."
SERVE OC, an ongoing study, aims to adapt previously established educational strategies for reducing vascular events and address primordial prevention of hypertension using community-based participatory research. This project is one of 2 projects under a larger community health initiative called UC End Disparities, which is working to prevent cardiometabolic disease across Los Angeles and Orange counties. The hypothesis behind SERVE OC is that a culturally-tailored, skills-based educational program will optimize successful long-term behavioral change for prevention of hypertension among adults and children within this region.
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