Our aim is to understand the associations between vascular risk factors, MRI findings, and cognitive impairment in a diverse population.

The DVCID study is a prospective observational multicenter project designed to enroll 2,250 individuals (ages range 65-90), evenly distributed among White, Black, and Hispanic individuals. The main goal of the project is to set up a risk profile for dementia that will help decrease the burden of the disease in a diverse population.

For this preliminary analysis, the cohort consisted of 996 individuals with baseline MRI and vascular risk assessment, categorized into normal and impaired cognition. Descriptive statistics and linear regression analyses were conducted on baseline MRI variables and vascular risk factors across racial and ethnic groups. WMH was log-transformed, and all MRI variables were adjusted for head size.

Across racial/ethnic groups, cognitive impairment was present in 39% of Black, 24% of White, and 29% of Latino participants. Compared with normal participants, those with cognitive impairment had significantly lower memory scores and visuospatial recall (p<0.001). Impaired participants exhibited a higher prevalence of hypertension (62.6% vs 55.6%; p=0.04), diabetes (25.0% vs 18.2%; p=0.02), and combined vascular comorbidities (HTN+DM+HCL: 18.5% vs 12.9%; p=0.02). MRI measures showed smaller total cerebral brain volume (p=0.007), reduced gray matter (p<0.001), and hippocampal volume (p<0.001) among impaired individuals. Regional cortical volumes were lower in frontal (p=0.01), temporal (p<0.001), and occipital (p=0.03) lobes. No significant differences were seen between groups for cortical thickness, WMH burden, or DTI-derived FA/FW.

Cognitive impairment varied by race and ethnicity and was associated with greater vascular risk burden and reduced gray matter and hippocampal volumes. The unequal distribution and its link to vascular profiles highlight potential disparities in vascular contributions to cognitive decline. Further analyses within the DVCID study will help establish a well-defined vascular risk profile for cognitive impairment.