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. 2022 Mar 10;3:3-6. doi: 10.17879/freeneuropathology-2022-3795

Table 1.

Literature with neuropathological data of Latinos/Hispanics and/or Black Americans. For the ethnicity/race column, the mentioned terms used in each respective paper stated are followed with the universal synonym in parentheses to provide consistency.

Citation (PMID)

Cohort and location* Numbers of Ethnicity/Race(s) examined Total cohort size

Pathologies examined

Inclusion/Exclusion Criteria Main findings

Sandberg G, …, Troncoso JC. Neurobiol Aging, 2001. (11182466)

Maryland ME office; study carried out at University of Maryland

☐ 58 African Americans (Black Americans)

☐ 80 Whites (NHWs)

138

☐ AD

Inclusion

  • Neuropath consultations at Maryland ME office between 1990 to 1998

  • Age between 40-79 years

  • Non-natural manner of death

  • No significance differences in prevalence of SP or NFT between groups.

Wilkins CH, …, Morris JC. Arch Neurol, 2006. (16401740). Washington University ADRC; greater metropolitan St. Louis, MO

☐ 10 African Americans (Black Americans)

☐ 10 Whites (NHWs)

20

☐ AD

☐ CVD

☐ LBD

Inclusion

  • Autopsy between 1990 to 2000

  • NHWs were matched to age (+/- 5 yrs of death, sex, and CDR at death

  • Over 50 yrs of age at enrollment

  • No significant neuropathological differences were found in both groups across all pathologies examined.

  • No group differences in the presence or number of infarctions, plaques, NFTs, Lewy bodies, CAA.

Riudavets MA, …, Troncoso JC. J Neuropathol Exp Neurol 2006. (17146288)

Maryland ME office; study carried out at University of Maryland

☐ 100 Blacks (Black Americans)

☐ 100 Whites (NHWs)

200

☐ AD

☐ CVD

Inclusion

  • Aged 65 to 95 years at death

  • Consecutive autopsies at Maryland ME office between 2002 to 2005

  • Race not a significant factor in frequency or severity of AD lesions (Amyloid Beta plaques and NFTs).

  • No significant difference in vascular lesions by race.

  • ApoE4 increased risk of AD lesions similarly in each race.

Mehta KM, ..., Miller BL. Neurology, 2008. (18003939)# >30 ADCs; NACC database

☐ 1,301 Latinos (Hispanics)

☐ 3,563 African Americans (Black Americans)

☐ 451 Asian

☐ 162 American Indians

☐ 25,160 Whites (NHWs)

30,916

(3,017 with npath)

☐ AD

☐ CVD

Inclusion:

  • Aged 65 yrs or older

  • Dx of possible/probable AD

  • Seen at an ADC between 1984-2005

Exclusion:

  • Identified as other race

  • Missing death data

  • African American and Latino/Hispanic patients had similar AD neuropathologies when compared to NHWs.

  • Both Latinos and African Americans were equally likely to have Braak NFT stages V and VI.

  • Neurovascular pathology and NP presence were more common in Latinos than NHW.

Ringman JM, ..., Vinters HV. JAMA Neurology, 2014. (24797962)* >30 ADCs; NACC database

☐ Hispanic (Latinos)

☐ African Americans (Black Americans)

☐ Whites (NHWs)

425

☐ AD

☐ CVD

Inclusion

  • Severe and no CAA

  • Cognitive impaired and meeting NIA Reagan criteria for AD

Exclusion

  • Did not identify as Hispanic, African Americans or NHW

  • Hispanics with neuropathologically confirmed AD more likely to have severe CAA than non-Hispanics.

  • African Americans did not differ significantly with NHWs.

Barnes LL, …, Schneider JA. Neurology, 2015. (26180136). Rush University, ADRC Chicago, Illinois

☐ 41 Blacks (Black Americans)

☐ 81 Whites (NHWs)

122

☐ AD

☐ CVD

☐ LBD

Inclusion

  • Consecutive autopsies, age, sex, education, and cognition matched NHWs to Black Americans ~2:1

  • Blacks with AD more likely to have mixed brain pathologies compared to NHWs with AD.

Graff-Radford NR, …, Dickson DW. Alz Dement, 2016. (27094726) 32 past/present ADCs; NACC database

☐ 110 African Americans (Black Americans)

☐ 2,500 White (NHWs)

2,610

☐ AD

☐ CVD

☐ LBD

☐ TDP/FTD

Inclusion

  • Available NACC data from 2005 to 2015

  • Dementia at last clinic visit and went to autopsy

Exclusion

  • Participants reporting a race other than African Americans or NHWs

  • AD neuropathologic change in January 2015; this data was excluded due to the small sample size with ADNC data to date

  • AD, LBD, and CVD more common in African Americans thank NHWs.

  • African Americans had higher Braak NFT Stage and CERAD when compared to NHWS.

  • African Americans had more CVD pathologies when compared to NHWs.

Kamara DM, …, Walker LC. J Alzheimers Dis, 2018. (29614657). Emory ADRC Atlanta, GA

☐ 18 African Americans (Black Americans)

☐ 19 Caucasians (NHWs)

37

☐ AD

☐ CVD

Inclusion

  • Autopsies between 2003 to 2014

  • End stage AD

  • Groups matched as close as possible for age, disease duration, APOE type, sex, level of education, and post-mortem interval

  • No significant differences in CAA in person with AD between groups.

Soria JA, …, Rissman RA. J Alzheimers Dis, 2018 (30412501)  UCSD ADRC San Diego, California

☐ 53 Latinos (Hispanics)

53

☐ AD

☐ CVD

☐ LBD

Inclusion

  • Older adults with Latino ethnicity

  • Autopsied from 1991 to 2017

Exclusion

  • Presenilin 1 mutation cases

  • interval between last clinical encounter and death > 2.5 years

  • Insulin-dependent diabetes, major stroke or neurological illness, or self-reported alcohol or drug abuse

  • Clinic dx of AD at last clinical evaluation had 97.1% sensitivity and 57.9% specificity against autopsy-verified AD in Latinos.

Filshtein TJ, …, DeCarli C. J Alzheimers Dis, 2019. (30775996) University of California, Davis (UCD) ADC; Sacramento, CA

☐ 28 Hispanic (Latinos)

☐ 35 Black (Black Americans)

☐ 360 NHWs

423

☐ AD

☐ CVD

Inclusion:

  • Dementia at last visit before death

  • went to autopsy between 2000 and 2017

  • Hispanics had lower (14%) AD (non-mixed) than NHWs (43%) and Black (43%).

  • Blacks and Hispanics had higher CVD (40% and 54% respectively) compared to NHWs (28%).

  • Most common neuropath dx was AD across all groups: 80.5% in NHWs, 80% in Black, and 67.9% in Hispanics regardless of concomitant diagnosis.

Santos OA, ..., Murray ME. Alz Dement, 2019. (30792090) Florida Autopsies Multi-Ethnic cohort (FLAME) State of Florida brain bank

☐ 67 Hispanic (Latinos)

☐ 19 African Americans (Black Americans)

☐ 1,539 Caucasian (NHWs)

2,809

☐ AD

☐ LBD

Inclusion:

  • Brain tissue was received on or before August 2015 within state of Florida brain bank

  • Autopsy confirmed AD cases regardless of clinical dx

Exclusion

  • Non-AD autopsy confirmed cases

  • AD cases with known mutations

  • Thal amyloid phase did not differ across all groups.

  • Hispanics were found to be twice as likely to have higher Braak NFT stage compared to NHWs.

  • African Americans did not differ from NHWs for Braak NFT staging.

Weissburger GH, ..., Salmon DP. J. Alzheimers Dis., 2019. (30636736) UCSD ADRC San Diego, California

☐ 14 Hispanic (Latinos)

☐ 20 NHWs

34

☐ AD

☐ CVD

Inclusion

  • Persons with AD dementia who died and autopsied between 1989-2016

  • >=95 on DRS at 1st clinical evaluation

Exclusion

  • Presenilin 1 mutations with early age of onset

**Insulin-dependent diabetes, major stroke or neurological illness, or self-reported alcohol or drug abuse

  • Groups had similar overall AD pathology burden.

  • Hispanics with AD had more small parenchymal arteriolar disease and CAA than NHW with AD.

  • Groups did not differ in other aspects of cerebrovascular pathology such as infarctions and/or hemorrhages.

# for Mehta et al. numbers of Ethnicity/Race(s) examined represent deceased persons, only a subset of cases (n= 3,017) had neuropathology data--npath details of ethnoracial group were not listed. *for Ringman et al. data within paper not sufficient to derive numbers of Ethnicity/Race(s) examined with neuropathologic evaluations. ** previous UCSD ADRC cohort studies state this exclusion, although not stated directly within paper. Abbreviations: AD=Alzheimer’s disease, ADC/ADRC= Alzheimer’s Disease (research) Center, CAA=cerebral amyloid angiopathy, CVD=Cerebrovascular disease related pathologies, DLB=Dementia with Lewy Bodies, DRS=Dementia rating scale, dx=diagnosis, NACC=National Alzheimer’s Coordinating Center, ME= medical examiner, npath=neuropathology, LBD= Lewy body dementia, FTD=Frontotemporal dementia, NFT=neurofibrillary tangles, NHW=Non-Hispanic Whites, UCSD=University of California San Diego. *Cohort name was listed if given and location includes medical center/institution/data source.