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Understanding Pathophysiology of White Matter Hyperintensities Post-Stroke
No full textBackground: White Matter Hyperintensities (WMH) are areas of brain white matter lesions that appear hyperintense upon imaging with MRI due to fluid collection. WMH can result because of cerebral small vessel disease, however, the exact underlying cause of WMHs has not been determined. Many studies have correlated the presence of WMH with an increased risk of cognitive decline and with cognitive impairment diseases such as dementia and Alzheimer’s disease, which as of the present day have no permanent cure. However, despite the pertinent correlation between WMH and cognitive impairment diseases, little is known about the specific pathophysiology and etiology of the fluid accumulation seen upon MRI imaging of the brain. Therefore, the goal of this project is to understand how changes to the lateral ventricular walls impact white matter hyperintensities post-stoke may be caused which can lead to cognitive impairment in the future. To obtain the necessary data, images will be taken from mice's brains to evaluate vessel changes in the ventricle walls pre- and post-stroke. For my part of the project, I evaluated the dorsal and lateral ventricle wall structure pre-stoke to understand the basic components of this area of the brain. Hypothesis: We hypothesize that the dorsal wall of the ventricle will contain more adherent junctions and fewer tight junctions, leading to fluid leakage, compared to the lateral wall of the ventricle, which will contain more tight junctions. Methods: The immunofluorescence (IF) staining method begins with a xylene wash to remove paraffin, followed by a series of ethanol rehydration steps. The samples are then washed in deionized water and PBS, and incubated in citrate buffer at 95-100°C for antigen retrieval. After cooling and applying a wax border, the samples are washed with PBST, blocked with a solution containing PBST and donkey serum, and incubated with primary antibodies at 4°C for 48 hours. The next day, the samples undergo multiple PBST washes, followed by incubation with secondary antibodies at room temperature for 1.5 hours. After additional PBST washes, DAPI is added for nuclear staining, and the samples are finally washed, mounted with prolong, and the cover slipped for imaging. Results and Conclusion: The lateral wall demonstrated less expression of N-cadherin, which stains for adherens junctions, compared to the dorsal wall. This finding supports the initial hypothesis that the dorsal wall contains more adherens junctions than the lateral wall. However, no significant difference was observed in the staining for Claudin and Occludin across the collected samples. Staining with Vimentin, which targets intermediate filaments, revealed that the lateral wall contains a higher cell density compared to the dorsal wall. Additionally, some samples (4, 6, 7, and 8) could not be evaluated due to issues with dysfunctional DAPI staining
Understanding Social Determinants of Health and Cognitive Impairment Risk in Diverse Populations Using Machine Learning: A HABS-HD Study
No full textPurpose: Previous studies have linked certain social determinants of health (SDoH) to Alzheimer’s disease and related dementias (ADRD). However, most studies have been focused on individuals of European ancestry, leaving a critical need to investigate the impact of SDoH in other understudied populations. This study examines the impact SDoH and related risk factors on cognitive impairment among three racial/ethnic populations: African American (AA), Mexican American (MA), and non-Hispanic White (NHW). Methods: This observational population-based study assessed 37 SDoH and related factors among a total sample of 3,229 participants from the Health and Aging Brain Study – Health Disparities (HABS-HD) cohort. Machine learning methods, eXtreme Gradient Boosting and random forests, were used to assess the importance of these risk factors based on their effect on predictive model performance, with the outcome of interest being cognitive impairment diagnosis. The overall population was stratified by each racial/ethnic group (i.e., AA, MA, and NHW) to determine race/ethnicity specific associations. The Shapley Additive exPlanations (SHAP) approach was used to determine the marginal contributions for each variable assessed across the models. Results: Income was among the top risk factors for all three groups. Excluding income, the next top three ranked predictors for the AA population were education, score for the Penn-State Worry Questionnaire (PSWQ), and national ranking of the area deprivation index. For the MA group, the top risk factors were score for the Geriatric Depression Scale (GDS), score for the PSWQ, and years lived in the United States. For the NHW population, the most important factors were score for the GDS, and self-reported health status. Conclusion: The study provides direct evidence of the varying importance of SDoH across a multi-ethnic community. We highlight communities at the highest risk for cognitive impairment based on SDoH factors. These findings support the implementation of ethno-racially specific intervention strategies that combine public health initiatives with comorbid disease management to prevent or delay the onset of ADRD in the United States
Bridging Policy Gaps: Understanding Prenatal Syphilis Screening Practices Amid Conflicting Guidelines
No full textPurpose: Congenital syphilis (CS) is a sexually transmitted disease which can cause miscarriage and birth defects. CS rates are rising nationally and within Texas thus creating a growing health concern. Fortunately, detection through prenatal screenings can identify cases early, improving treatment and reducing negative birth outcomes. To address the trend of rising CS rates, in 2019, the Texas Department of State Health Services amended state policy and added a third syphilis screening recommendation at delivery. However, Texas screening policy differs from national organization guidelines such as those recommended by the American College of Obstetricians and Gynecologists (ACOG). The inconsistencies between national screening guidelines and state level policies for syphilis screening may contribute to the growing health disparity gap. This study examines how prenatal care providers navigate conflicting syphilis screening guidelines including the factors that influence their decision to follow either state policies or national organization guidelines. Methods: Semi-structured interviews were conducted with prenatal providers (certified nurse-midwives, physician assistants, nurse practitioners, and physicians; n=18), guided by the Consolidated Framework for Implementation Research (CFIR). The CFIR is a framework used to evaluate the implementation of evidence-based interventions or practices. Interviews were audio-recorded and transcribed verbatim. Data were thematically analyzed using MAXQDA software and coded with CFIR constructs to identify key themes in policy implementation and decision-making. Results: Participants varied in the factors which shaped their decisions regarding state and national syphilis screening practices. Some providers prioritized state-mandated law to protect their licensure in Texas, while others complied with employer-enforced policies and implementation of recommendations to avoid termination of employment. Other respondents provided an individualized screening plan according to their patients’ risks and needs, regardless of the guidelines and policies. Most providers preferred to follow ACOG guidelines and viewed information from this organization as the gold standard for obstetric care. Conclusion: Findings of this study revealed inconsistent syphilis screening practices among prenatal care providers pointing to a lack of uniformity of policy implementation in healthcare. Conflicting guidelines in clinical practice highlight the need for future research to understand barriers to policy adoption at both provider and system levels across diverse clinical settings. Strategies aimed at providing a system-wide implementation of consistent syphilis screening policy can improve CS detection and reduce adverse maternal and infant outcomes in both Texas and across the nation
Investigating the relationship between skin color, ethnicity, and the Fitzpatrick skin scale
No full textBackground: The Fitzpatrick skin scale has long been used as a proxy for skin tone categorization.¹,² However, its initial creation was to classify reactivity of white skin to ultraviolet A radiation.¹,² A reported one-third of dermatologists conflate the Fitzpatrick skin scale for race and ethnicity.³ Approximately half of the dermatologists also reported utilizing the Fitzpatrick scale to describe skin color.³ The goal of this study was to compare the Fitzpatrick scale to skin color and ethnicity in a larger, cohort including the full spectrum of skin tones. Methods: Subjects completed a standardized questionnaire. The questionnaire encompassed subjective classification methods: self-reported skin color descriptors (very fair, fair, olive, light brown, dark brown, and very dark), self-assessed Fitzpatrick skin type (I-VI) and ethnicity. The questionnaire included the following ethnicities: White, Asian, African American or Black, Hispanic or Latino, Native Hawaiian or Pacific Islander, Multiple Ethnicities, and Other. If more than one ethnicity was chosen, the subject was reported as “multiple ethnicities.” Chi-squared tests were performed comparing skin color and ethnicity to Fitzpatrick skin type. Results: 440 subjects completed the questionnaire. Chi squared test revealed that each Fitzpatrick type was composed of significantly different proportions of skin colors (p < 2.2e-16). There was a weak association between Fitzpatrick type and self‐described skin color (Cramér’s V=0.3). While there is a significant difference in the percentage of each ethnicity found in each Fitzpatrick type (p < 2.2e-16), each ethnicity could not be modeled off individual Fitzpatrick types. There was representation from all ethnicities in each Fitzpatrick type. There was a weak association between Fitzpatrick-type and ethnicity (Cramér’s V=0.3). Conclusion: This study confirms previously cited flaws of the Fitzpatrick scale. Our study found no statistically significant proportion of a singular skin color descriptor or ethnicity within each Fitzpatrick skin type. This serves as emphasis that there is no relationship between physical traits or cultural identity with the Fitzpatrick scale
Enhancing Student Skills: The Impact of Peer-Led Mock OSCE on Competence and Perceptions
No full textPurpose: This study evaluates the impact of a peer-led mock OSCE (MOSCE) before a low-stakes OSCE on students' performance in both low- and high-stakes OSCEs, perceptions of OSCE readiness, and peer tutors’ experiences. Methods: P2 and P3 students served as peer graders and simulated patients for a P1 physical assessment MOSCE that tested students on communication, blood pressure and pulse assessment, and diabetic foot exam assessment skills. P1 participants completed pre- and post-MOSCE surveys assessing confidence and preparedness for the high-stakes OSCE, while non-participants were also surveyed for comparison. Peer graders provided feedback via post-MOSCE surveys. OSCE station grades were analyzed to assess the link between MOSCE participation and student performance, preparedness, and confidence using Chi-square, independent samples t-tests, and paired t-tests in SPSS version 29. Results: 30 (39%) attended the MOSCE before the low-stakes OSCE. Among them, 20 (66.7%) passed the low-stakes OSCE (p=0.09), and 26 (86.7%) passed the high-stakes OSCE (p=0.14), compared to pass rates of 46.8% and 72.3% for non-participants, respectively. While MOSCE participants had higher average low-stakes OSCE scores (48.59±3.77 vs. 46.57±6.09, p=0.11), the difference was not statistically significant. However, participation was associated with significantly higher high-stakes OSCE scores (49.56±3.20 vs. 47.56±4.72, p=0.03). When the MOSCE was offered in Fall 2023 before the high-stakes OSCE, participation (n=34) was not associated with improved high-stakes OSCE scores (50.1±2.75 vs. 50.0±3.36, p=0.88) or pass rates (p=0.77). Survey results indicated that 50% of MOSCE participants (n=10) had prior clinical or pharmacy experience, and 80% had practiced beforehand. Post-MOSCE, participants reported significantly greater preparedness (3.30±0.48 vs. 2.50±0.53, p<0.001), confidence in taking medical and social histories (3.10±0.57 vs. 2.50±0.53, p=0.005), and confidence in performing a diabetic foot exam (3.20±0.42 vs. 2.50±0.53, p=0.001). All survey respondents agreed that the MOSCE was beneficial, improved communication skills, and valued peer feedback. Among peer tutors (n=17), responses indicated that the MOSCE reinforced physical assessment skills, fostered an appreciation for peer-led learning, and provided a valuable teaching experience. The most appreciated aspects included the peer-led format (82.4%), clinical scenario simulation (70.6%), and peer-driven feedback (58.8%). Conclusions: While MOSCE participation did not significantly impact low-stakes OSCE performance, it was associated with improved high-stakes OSCE performance; whether this was due to increased exposure and practice or participation in the low-stakes OSCE remains unclear. Moreover, the benefit of timing the MOSCE before the low-stakes vs. the high-stakes OSCE is not completely understood. However, MOSCE attendance significantly enhanced OSCE readiness and was beneficial to both participants and peer tutors. Expanding MOSCE availability and incorporating multiple practice opportunities may further enhance skill development through peer-led learning
Sex Differences in Cerebrum miRNAs, Mitochondrial Translation Elongation Factor, Electron Transport Chain Proteins, and Blood Pressure in Adult IUGR Rats
No full textIntroduction: Fetuses that do not grow to normal weight in utero, also known as intrauterine growth restriction (IUGR), have an increased risk of developing hypertension (HTN) in adulthood, especially males. The sex difference in blood pressure may be due to cerebral mitochondrial dysfunction and oxidative stress. Epigenetic changes, such as miRNA, can alter mitochondrial development, structure, and function to increase oxidative stress. The purpose of this study is to observe the changes in differentially expressed miRNAs and blood pressure of male (M) and female (F) IUGR rats. We hypothesize that adult IUGR rats, particularly males, will display high blood pressure (HBP) and increased expression of miRNAs that influence cerebrum mitochondrial function, electron transport chain (ETC) proteins, and oxidative stress. Methods: To perform these experiments, IUGR and control (CON) M and F Sprague Dawley rats were evaluated at 16-18 weeks (adulthood). CON pups were produced from normal pregnant dams, and IUGR pups were generated from placental ischemic dams. Results: Results show that IUGR M have HBP (136±2 vs 120±7 mmHg, p=0.0488) compared to CON M, while IUGR F exhibit no difference in blood pressure vs CON F. Using Ingenuity Pathway Analysis (IPA), we identified 11 differentially expressed miRNAs in IUGR vs CON rats. Nine miRNAs that were differentially expressed in IUGR M vs CON M, six miRNAs in IUGR F vs CON F, and four shared downregulated miRNAs in IUGR rats from both sexes. miRNA let-7d-3p was uniquely upregulated in IUGR M vs CON M and had a 1.2-fold increase in expression between IUGR M vs CON M (1.2±0.2 vs 1.0±0.1-fold-change, ns) with qPCR. GFM-1, the gene for mitochondrial elongation factor G1 that is predicted to be regulated by let-7d-3p, increased in IUGR F vs CON F (114±2 vs 100±4 IU/Protein/CON%, p=0.013) and did not change in M. ETC proteins were unchanged in M, but complexes 3 (110±4 vs 100±2 IU/Protein/CON%, p=0.068) and 4 (121.1±4.3 vs 100±5.5 IU/Protein/CON%, p=0.013) were elevated in IUGR F vs CON F. There were no alterations in oxidative stress for F, but a ~50% increase in H₂O₂ concentration in IUGR M vs CON M (3.3±0.9 vs 1.8±0.4 nmol H₂O₂/mg Protein, p=0.1254). Conclusion: In summary, IUGR M have HBP and an increase in let-7d-3p expression in the cerebrum. We predict that the increase in let-7d-3p inhibited the compensatory increase in GFM-1 and ETC proteins that are needed to prevent cerebrum oxidative stress and HBP in IUGR M. However, unchanged let-7d-3p in IUGR F vs CON F, allowed for the increase in GFM-1 and ETC proteins to inhibit cerebrum mitochondrial dysfunction, oxidative stress, and HBP. Findings from this study will provide insights into the pathway linking epigenetic changes to mitochondrial dysfunction, oxidative stress, and HTN in adults born IUGR
Development and Implementation of a Personal Virtual Assistant for Patient Engagement and Communication in Postsurgical Cancer Care: Feasibility Cohort Study
Get PDFBACKGROUND: Cancer-care complexity heightens communication challenges between health care providers and patients, impacting their treatment adherence. This is especially evident upon hospital discharge in patients undergoing surgical procedures. Digital health tools offer potential solutions to address communication challenges seen in current discharge protocols. We aim to explore the usability and acceptability of an interactive health platform among discharged patients who underwent oncology-related procedures. METHODS: A 4-week exploratory cohort study was conducted. Following hospital discharge, a tablet equipped with an integrated Personal Virtual Assistant (PVA) system was provided to patients who underwent oncology-related procedures. The PVA encompasses automated features that provide personalized care plans, developed through collaboration among clinicians, researchers, and engineers from various disciplines. These plans include guidance on daily specific assignments that were divided into 4 categories: medication intake, exercise, symptom surveys, and postprocedural specific tasks. The aim was to explore the acceptability of the PVA by quantification of dropout rate and assessing adherence to each care plan category throughout the study duration. The secondary aim assessed acceptability of the PVA through a technology acceptance model (TAM) questionnaire that examined ease of use, usefulness, attitude toward use, and privacy concerns. RESULTS: In total, 17 patients were enrolled. However, 1 (5.8%) patient dropped out from the study after 3 days due to health deterioration, leaving 16/17 (94.2%) completing the study (mean age 54.5, SD 12.7, years; n=9, 52% Caucasian; n=14, 82% with a gynecological disease; n=3, 18% with a hepatobiliary disease). At the study end point, adherence to care plan categories were 78% (SD 25%) for medications, 81% (SD 24%) for exercises, 61% (SD 30%) for surveys, and 58% (SD 44%) for specific tasks such as following step-by step wound care instructions, managing drains, administering injectable medications independently, and performing pelvic baths as instructed. There was an 80% patient endorsement (strongly agree or agree) across all TAM categories. CONCLUSIONS: This study suggests the potential acceptability of the PVA among patients discharged after oncology-related procedures, with a dropout rate of less than 6% and fair-to-good adherence to tasks such as medication intake and exercise. However, these findings are preliminary due to the small sample size and highlight the need for further research with larger cohorts to validate and refine the system.The authors would like to thank Drs William E Fisher, Ernest Ramsay Camp, Ang Li, Amir Sharafkhaneh, and Feibi Zheng from Baylor College of Medicine for their expert advice in evaluating and building content for the Personal Virtual Assistant (PVA). The authors would also like to thank Martyn Molnar, Paul Costello, and Dr Sammer Sood from SmartTek21 and IntelliTek Health for their in-kind and technical support for PVA used in this study. We also extend our gratitude to Maria Noun and Naima Rodriguez for their support with the institutional review board and operations, and to the Digital Health Access Center team as well as the clinical team at the Baylor College of Medicine (BCM) Dan L Duncan Comprehensive Cancer Center and the BCM St. Luke's Medical Center for their assistance with patient referral and recruitment. This research was supported by the National Science Foundation's Industry-University Cooperative Research Centers program under award numbers NSF 2052514 and C2SHIP (Center to Stream HealthCare in Place) Y01-BCM-P026. Additional support was provided by the National Institutes of Health, National Cancer Institute under award number 5P30CA125123-17S1, and in-kind support from Smartek21 and IntelliTek Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the sponsors
Leading Predictors and their Associations with Robotic Surgery among Older Adults with Incident Colorectal Cancer (CRC): An interpretable Machine Learning Approach
No full textPoster Highlight: Texas College of Osteopathic Medicine - Research, RAD 2025 Award Winning Posters & Oral PresentationsTITLE: Leading Predictors and their Associations with Robotic Surgery among Older Adults with Incident Colorectal Cancer (CRC): An interpretable Machine Learning Approach BACKGROUND: Surgery is the primary treatment for individuals with colorectal cancer (CRC). Robotic surgery has been shown to reduce complications and shorten recovery time among older adults compared to laparoscopic or open surgery. However, disparities in robotic surgery adoption are influenced by social determinants of health (SDOH). OBJECTIVE: To identify leading predictors and their associations with robotic surgery among older adults with incident CRC using an interpretable machine learning (ML) model. METHODS: Study Design: A retrospective cohort study was conducted with baseline and follow-up periods. The cohort included older adults (age >66) diagnosed with CRC (N = 16,402) from 2014 to 2018. The baseline period covered the 12 months before diagnosis, while follow-up extended 12 months after diagnosis. Data Sources: Our data primary data sources were: 1) the Surveillance, Epidemiology, and End Results (SEER) program and 2) Medicare Claims data to derive Medicare paid treatments. SEER collects detailed information on demographics, tumor characteristics, cancer treatment received, and survival outcomes from cancer registries. We augmented the data with 3) Area Health Resource File for county-level health infrastructure data; and 4) census tract level database from the SEER to measure social determinants of health (example: education, and income). Study Population: Eligibility required continuous Medicare Part A, B, and D enrollment during baseline and follow-up. Individuals enrolled in HMOs or diagnosed during autopsy or with missing cancer stage were excluded, resulting in 16,402 participants. Measures: The model included 29 features at patient and community levels, such as age, sex, race/ethnicity, SDOH (marital status, education, poverty, metro status, fragmented care, emergency room use), cancer stage, polypharmacy, other treatments, alcohol, and tobacco use. The target variable was robotic surgery (Yes/No), identified using ICD-9 and ICD-10 codes from Medicare claims. Machine Learning Analyses: eXtreme Gradient Boosting (XGBoost) classifiers identified key predictors. SHapley Additive exPlanations (SHAP) were used for interpretation. Model development involved a 70/30 training/testing split, 10-fold cross-validation, and hyperparameter tuning in Python. Performance metrics included accuracy, precision, recall, and AUC. RESULTS: Robotic surgery was utilized in 2,926 (15.2%) of older adults. Descriptive analyses revealed disparities: men (17.5%) received robotic surgery more than women (13.6%), while poor individuals (12.5%) and those not married (14.3%) had lower rates compared to their counterparts (16.1% and 16.3%, respectively). The model demonstrated strong performance, with an AUC of 0.93, precision of 0.983, and recall of 0.79. Leading predictors included regional cancer stage, other cancer therapies, metro residency, and alcohol use. SDOH factors such as region, fragmented care, and emergency room use were among the top 10 predictors. SHAP analysis indicated regional cancer stage was associated with higher robotic surgery likelihood, while SDOH showed complex associations. CONCLUSION: Only about 15% of older adults with CRC received robotic surgery, despite its benefits. Significant disparities were observed, driven by SDOH such as healthcare access and geographic location. Targeted interventions addressing these disparities may promote health equity
Low Morbidity and Mortality in Patients with Turner Syndrome and Hypoplastic Left Heart Syndrome – a single center experience
No full textBackground: Turner Syndrome (TS) is the complete or partial loss of a single X chromosome and occurs in 1/2500-3000 births. Around 50% of patients with TS also have congenital heart disease (CHD), including hypoplastic left heart syndrome (HLHS). Previous studies have reported that patients with TS and HLHS had a high morbidity and mortality (overall mortality around 82%). The purpose of this study is to determine the morbidity and mortality of patients with both TS and HLHS at Cook Children’s Medical Center. We hypothesis that morbidity and mortality of patients with TS and HLHS will be low. Methods: We conducted a single-center retrospective study including patients with a diagnosis of TS and HLHS who had their surgical palliations performed at Cook Children’s Medical Center between 2013 and 2024. Six patients were identified that met these inclusion criteria. Variables including timing of operations, operative times, need for additional surgeries/interventions, length of stay (LOS), and transplant free survival was analyzed for all patients. Results: All patients underwent Stage 1 operation between days 2 and 9 of life. Median intubation and chest tube duration were 9 and 7 days, respectively. Median cardiac intensive care unit (CICU) and total hospital LOS were 20 and 44 days, respectively. One patient (17%) required surgical revision of aortopulmonary shunt prior to discharge and two separate patients (34%) required catheter-based intervention of the shunt. All patients subsequently underwent Stage 2 operation at a median age of 5 months. All patients were extubated by post operative day (POD) 2 with a median chest tube duration of 6 days. Median CICU and total hospital LOS were 4 and 12 days, respectively. Four patients (67%) underwent stage 3 operation and were all extubated by POD 3 with a median chest tube duration of 11 days. Median CICU and total hospital LOS were 8 and 14 days, respectively. Five patients (83%) are alive with 1/5 patients requiring heart transplant following Fontan (transplant free survival: 67%). One patient died at home due to unknown causes prior to Fontan (1 year of age). Conclusion: This case series represents a unique single center series of patients with TS and HLHS demonstrating low morbidity and mortality. While it is difficult to determine reasons for their improved survival compared to others previously reported outcomes in patients with HLHS and TS, differing strategies of Sano modification, pulsatile Glenn operation off cardiopulmonary bypass, perfusion and ultrafiltration strategies, and fenestrated Fontan likely play a role in the improvement in capillary leak and hemodynamics. Although this is a small patient population, patients with TS and HLHS can demonstrate good outcomes and should be considered for the single ventricle pathway
Comparing Characteristics Among Three Cohorts: Blacks, Hispanics, and Non-Hispanic Whites With Motoric Cognitive Risk Syndrome
No full textPurpose: Motoric Cognitive Risk Syndrome (MCR) is being explored as an early predictor for the risk of developing dementia. MCR combines Subjective Cognitive Concern (SCC) and slowed gait in a cognitively unimpaired group. MCR evaluation can be performed in clinical settings without extensive testing and imaging. There is inadequate representation of Blacks and Hispanics in studies on aging and cognitive decline and later clinical diagnosis. Current studies suggest that Blacks and Hispanics have a higher prevalence of dementia. The purpose of this study was to examine how the characteristics of MCR differ among: Blacks, Hispanics, and non-Hispanic whites (NHW). Methods: Participants: Data from the Health and Aging Brain: Health Disparities were utilized. The sample consisted of 2,358 cognitively unimpaired participants with ages ranging from 50-90. The MCR score was defined as 1 standard deviation above the mean (based on gender and these age categories 50-59, 60-69, and 70+ combined by age and gender) for the fastest of two, four-meter gait speed walk tests and the SCC. SCC was defined as a cognitively unimpaired individual with a complaint of a memory or thinking problem. Individuals without a gait speed measurement were removed from the sample. The sample of participants with MCR was n=170 with 45 NHWs, 99 Hispanics, and 26 Blacks. ANOVAs compared age, education, current depression, and lab values. Chi-squared tests compared differences in the groups for categorical variables. Results: Consistent with our hypothesis, there were differences in characteristics for individuals with MCR in the three cohorts. There was a significant effect of the amount of education, age, and Hba1c [F (2) = 47.743, p = 0.0], [F (2) = 11.715, p =0.0], [F (2) = 23.857, p = 0.0] on individuals in the three cohorts. A chi-squared test of independence was performed to evaluate the relationship between ethnicity and diabetes. The relationship between these variables was significant, x² (2, N= 170) = 8.5, p < 0.015. 9 out of the 19 characteristics analyzed returned with significant differences between the three cohorts. Conclusion: These findings highlight that differences exist between characteristics of MCR among: Blacks, Hispanics, and non-Hispanic whites (NHW). This corresponds with current findings, especially regarding the history of clinical diagnosis among participants, especially type 2 diabetes. Overall, MCR can be used to provide earlier detection of dementia for groups who may suffer due to lack of access to healthcare. Our research was limited by the number of participants analyzed and participants are predominantly female. MCR excludes those with physical disability limiting their mobility. In the future, another measure of physical activity can be used that is more inclusive to those who are unable to complete the gait speed test