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Salud Pública

Shruthi Venkatesh1, Linshanshan Wang2,3, Michele Morris1

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Resumen
Este resumen es generado por máquina.

Las minorías raciales y étnicas con enfermedad de Alzheimer (EA) enfrentan mayores riesgos de admisión en hogares de ancianos, mientras que los blancos no hispanos y los hombres con EA tienen mayores riesgos de mortalidad. Comprender estas disparidades es crucial para una atención equitativa.

Palabras clave:
enfermedad de Alzheimerdisparidadessalud públicahogares de ancianosmortalidadrazaetniagéneroatención equitativa

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Área de la Ciencia:

  • Neurología
  • Salud Pública
  • Gerontología

Sus antecedentes:

  • La enfermedad de Alzheimer (EA) impone una carga social significativa, con disparidades entre los grupos demográficos.
  • La investigación existente destaca la distribución inequitativa del impacto de la EA.
  • Este estudio aborda la necesidad de comprender las variaciones demográficas en los resultados de la progresión de la EA.

Objetivo del estudio:

  • Investigar las diferencias en los resultados del deterioro de la enfermedad de Alzheimer (EA) según la raza, la etnia y el género.
  • Identificar disparidades demográficas específicas en la admisión en hogares de ancianos y la mortalidad.
  • Informar sobre estrategias clínicas y de salud pública específicas para la EA.

Principales métodos:

  • Se utilizaron datos de registros de salud electrónicos (RSE) de dos grandes sistemas de atención médica (1994-2022).
  • Se aplicó un algoritmo de fenotipado no supervisado para predecir el estado de diagnóstico de EA, validado con datos de referencia.
  • Se realizaron análisis de supervivencia y metaanálisis de efectos fijos para comparar los resultados (admisión en hogares de ancianos, muerte) estratificados por raza, etnia y género, controlando las covariables.

Principales resultados:

  • El algoritmo de fenotipado logró una alta precisión (AUROC 0.835-0.923) en la identificación de pacientes con EA.
  • Incluyó 34,181 pacientes con EA (62% mujeres, 90% blancos no hispanos, edad media al diagnóstico 80.39 años).
  • Los pacientes blancos no hispanos tuvieron un menor riesgo de admisión en hogares de ancianos (HR=0.825) pero un mayor riesgo de muerte (HR=1.381) en comparación con las minorías.
  • Las mujeres tuvieron un menor riesgo de muerte (HR=0.873) pero un riesgo similar de admisión en hogares de ancianos en comparación con los hombres.

Conclusiones:

  • Las minorías raciales y étnicas con EA muestran un mayor riesgo de admisión en hogares de ancianos.
  • Los pacientes blancos no hispanos y los hombres con EA presentan un riesgo elevado de muerte.
  • La investigación adicional sobre las disparidades demográficas en el deterioro de la EA es esencial para mejorar la atención clínica y las políticas de salud pública.