HAI Book 2025 - Flipbook - Page 118
Ekuta, Victor
8
Understanding the impact of race on white matter hyperintensities in
Alzheimer9s disease: Findings from the ADNI Study
Victor Ekuta1, Jordan Ahn2, Yorghos Tripodis2, Roy Hamilton3
1
Morehouse School of Medicine, Atlanta, GA, US
Boston University School of Public Health, Boston, MA, US
3
Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, US
2
Background: White matter hyperintensities (WMH) are markers of small vessel disease associated with cognitive
decline and Alzheimer9s disease (AD). African Americans (AAs) are disproportionately affected by cerebrovascular
risk factors, but their representation in WMH research remains limited.
Objective: This study examined the relationship between race, cognitive status, and WMH burden among African
American (AA) and non-Hispanic White (NHW) participants, aiming to identify potential racial differences in WMH
burden.
Methods: Data from the Alzheimer9s Disease Neuroimaging Initiative (ADNI) were analyzed, including 1,649
participants: 682 cognitively normal (CN), 584 with mild cognitive impairment (MCI), and 383 with AD. Of these, 124
participants (7.5%) were African American: CN (70, 10.26%), MCI (39, 6.68%), and AD (15, 3.92%). Linear mixed
effects models were employed to assess the influence of race, cognitive status, and demographic factors on total
WMH burden.
Results: Preliminary analyses revealed that factors such as time since MRI, age, intracranial volume, and MRI
acquisition type significantly predicted total WMH across cognitive states. Time since the first MRI scan, age, and
intracranial volume were positively correlated with increased total WMH volume, with the strongest associations
seen in the dementia subgroup. MRI acquisition type (FLAIR) was negatively associated with WMH, suggesting
that newer MRI techniques are more sensitive in detecting WMH. Higher education levels were associated with
decreased WMH burden, indicating a potential protective effect. However, after controlling for other factors, race
did not independently predict WMH burden.
Conclusion: These findings suggest that while race was not an independent predictor of WMH burden, other
demographic and clinical factors such as age, education, and MRI methods significantly influenced WMH volumes.
Further research is needed to explore protective factors against WMH accumulation, particularly in racially
diverse populations.
Keywords: White matter hyperintensities, race, Alzheimer’s disease, cognitive status, cerebrovascular risk factors
HAI2025 - 118
