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INTRODUCTION Mild cognitive impairment (MCI) represents a transitional stage between normal aging and dementia. We investigate associations among cardiovascular and metabolic disorders (hypertension, diabetes mellitus, and hyperlipidemia) and diagnosis (normal; amnestic [aMCI]; and non‐amnestic [naMCI]). METHODS Multinomial logistic regressions of participant data (N = 8737; age = 70.9 ± 7.5 years) from the National Alzheimer's Coordinating Center Uniform Dataset Version 3 protocol cohort were used. RESULTS Controlling for demographic/health variables, individuals with aMCI, though not naMCI, showed a higher likelihood of hypertension, diabetes, and hyperlipidemia compared to cognitively normal counterparts, though no differences between aMCI/naMCI. Black Americans, regardless of cognitive status, were more likely to fall into hypertension and diabetes groups compared to White Americans. DISCUSSION These findings underscore the critical role of diagnosis and race in MCI diagnosis and care, emphasizing the need for tailored interventions to address inequities and reduce the risk of progression to dementia. Highlights The study leverages a large, racially diverse cohort from the NACC database.  Black Americans with non‐amnestic mild cognitive impairment(naMCI) show highest comorbidity burden. No significant differences in comorbidity burden between amnestic MCI (aMCI) and naMCI subtypes.  Education is protective, but less so for Black American individuals. Older age, male sex, body mass index (BMI), and low education associate with increased risk for comorbidities.

Abstract Assessing comorbidities associated with a MCI diagnosis is crucial for diagnostic accuracy and for understanding the role of comorbidities in cognitive decline. In this study of amnestic (aMCI) and non-amnestic (naMCI) MCI participants and persons with normal cognition (CN), we compared the prevalence of three primary comorbidities: Hypertension (HTN), Hyperlipidemia (HLD), and Diabetes Mellitus (DM) across African American and White populations using Chi-squares. Participant data (N = 9,342, 17% African American) were available through the National Alzheimer’s Coordinating Center and included: CN (n = 5,963; MOCA mean=27), aMCI (2,694; MOCA=22), and naMCI (685; MOCA=24) with diagnosis and data per their first Uniform Data Set (Version 3) visit. Significant differences in the distribution of HTN, HLD, and DM were found among the diagnostic groups for the total cohort and racial groups, separately; however, diagnostic differences across races were not always consistent. The relative rates of DM and HLD across the diagnostic groups for both races were generally similar, though higher percentages were seen in African Americans (25% of African Americans, 10% of Whites). As for HTN (52% of African Americans, 39% of Whites), however, the distributions differ across the diagnostic groups and race (%yes for diagnosis; White Americans: CN 35%, aMCI 47%, naMCI 44%; African Americans: CN 66%, aMCI 70%, naMCI 79%, p< 0.001). These findings highlight the importance of considering the contributions of both race and diagnosis when evaluating the role of comorbid factors and metabolic disorders in NC and MCI groups, in particular when considering blood pressure-related measures.