Hypertension and 10-Year Dementia Risk Among Older Asian American and Non-Latino White Adults in Northern California

INTRODUCTION: Hypertension is a modifiable risk factor for dementia, but its contribution among Asian American ethnic groups remains understudied despite heterogeneity in cardiovascular risk factors. METHODS: Participants were Kaiser Permanente Northern California members aged 60 to 90 years without prevalent dementia at baseline, surveyed between 2002 and 2009 [Chinese (n=4,848), Filipino (n=4,130), Japanese (n=2,786), South Asian (n=823), non-Latino White (n=123,593)]. We used ICD-codes to identify hypertension (assessed 5 y before baseline) and incident dementia through 2020. Within strata of race/ethnicity and baseline age group (60 to 75 and 75 to 90 y), we estimated adjusted and standardized 10-year dementia risk, risk ratios, risk differences, and population attributable fractions (PAFs) using pooled logistic regression, treating death as a censoring event. RESULTS: Among Chinese, Filipino, Japanese, and non-Latino White participants aged 60 to 75 years, PAFs (95% CI) were 12% (-3% to 28%), 23% (4% to 40%), 9% (-7% to 27%), and 8% (5% to 10%), respectively. Effect estimates were null for these groups among participants aged 75 to 90. For South Asian participants, point estimates were consistent with protective associations among those aged 60 to 75 and harmful associations among those aged 75 to 90, although estimates were imprecise. CONCLUSION: Our findings suggest heterogeneity in the effect of hypertension on dementia risk across Asian American ethnic groups and by age.