Vascular Risk Factors and Cognition in Individuals From Puerto Rico: Moving Away From Monolithic Racial and Ethnic Categories in Research

It has long been understood that cerebrovascular disease is a major contributor to the development of cognitive impairment. Correspondingly, mounting evidence indicates that risk factors for cerebrovascular disease are also associated with the development of cognitive deficits. For instance, hypertension and diabetes have been shown to increase the risk of developing Alzheimer disease, and cognitive decline more broadly, by inducing ultrastructural changes and ischemic injury to brain structures.1 Unfortunately, these risk factors are often disproportionately represented among persons from certain marginalized racial and ethnic groups. Notably, individuals from Puerto Rico have been shown to have a higher incidence of conditions such as diabetes and hypertension than non-Hispanic White persons or other North American Hispanic populations.2,3 However, despite the disproportionate burden that vascular disease has on some minoritized populations, most studies that have examined the interaction between vascular risk factors and cognition have focused on White, non-Hispanic populations, contributing to an incomplete understanding of how cerebrovascular risk factors and cognition interact in boarder, more diverse populations.