了解退伍军人痴呆症患病率中的种族差异
Melanie Arenson1,2, Amber Bahorik3, Feng Xia4,5
1Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA.
Journal of Alzheimer's disease : JAD
|July 12, 2024
概括
黑人和西班牙裔退伍军人面临更高的痴呆风险. 心血管疾病和健康的社会决定因素在很大程度上导致了这些差异,突出了干预的关键目标.
科学领域:
- 老年学是一门学科.
- 神经科学是一个神经科学.
- 公共卫生 公共卫生
背景情况:
- 阿尔茨海默病和相关痴呆症 (ADRD) 发病率的种族和民族差异明显,黑人和西班牙裔老年人患病率高于白人成年人.
- 导致这些差异的根本因素仍然不太清楚,阻碍了有效干预措施的发展.
- 退伍军人代表了研究ADRD差异的独特人群,因为他们拥有全面的健康记录和人口多样性.
研究的目的:
- 调查人口统计学,心血管疾病 (CVD) 和其风险因素,健康的社会决定因素 (SDOH) 和神经精神病学因素对美国退伍军人痴呆风险差异的影响.
- 量化这些因素对观察到的退伍军人人口中痴呆发病率的种族/种族差异的贡献.
主要方法:
- 一项回顾性队列研究,利用国家退伍军人卫生管理局 (VHA) 从1999年10月1日到2021年9月30日的数据.
- 纳入标准:1,579,919名老年退伍军人 (年龄≥55) 在基线没有痴呆症诊断.
- 统计分析涉及考克斯比例危险回归模型,以评估种族/种族群体的痴呆风险,控制各种人口,临床和社会因素.
主要成果:
- 在平均11.1年的随访期间,13%的退伍军人患上了痴呆症.
- 与白人退伍军人相比,黑人退伍军人患痴呆症的风险比率 (AHR) 增加了1.65倍,西班牙裔退伍军人患痴呆症的AHR增加了1.50倍,在调整性别和年龄后.
- 考虑到心血管疾病和风险因素后,黑人退伍军人的AHR降至1.53,西班牙裔退伍军人的AHR降至1.38. 在考虑SDOH时,黑人退伍军人的AHR为1.46和西班牙裔退伍军人的1.34.
结论:
- 健康的社会决定因素 (SDOH) 和心血管疾病 (CVD) 风险因素解释了退伍军人中痴呆风险种族/民族差异变异的最大比例.
- 针对心血管疾病和SDOH的干预措施为减轻该人口中痴呆风险差异提供了有希望的策略.
- 解决这些可修改的因素对于减少痴呆病发病率的健康不平等至关重要.
相关概念视频
Dementia
110
Dementia is a collective term for cognitive disorders primarily affecting memory, thinking, and reasoning. It is not a specific disease but a syndrome, with Alzheimer's disease being the most common cause, accounting for approximately 60-80% of cases. Other types include vascular dementia, Lewy body dementia, and frontotemporal dementia. Dementia affects millions worldwide, particularly older adults, though it is not a normal part of aging.
The progression of dementia is generally gradual....
The progression of dementia is generally gradual....
110
Alzheimer's Disease: Overview
461
Alzheimer's Disease (AD) is a continually advancing neurodegenerative disorder, distinguished by escalating memory loss, cognitive dysfunction, and dementia. The disease unfolds in three stages: preclinical, mild cognitive impairment (MCI), and dementia. Its onset is insidious, and the progression gradual, with the cause not well explained by other disorders.
The clinical diagnosis of AD hinges on the presence of memory and other cognitive impairments. Biomarkers, such as changes in Aβ...
The clinical diagnosis of AD hinges on the presence of memory and other cognitive impairments. Biomarkers, such as changes in Aβ...
461
Bias in Epidemiological Studies
230
Biases can arise at various stages of research, from study design and data collection to analysis and interpretation. Recognizing and addressing these biases is essential to ensure the validity and reliability of epidemiological findings.Broadly speaking, biases in epidemiology fall into three main categories: selection bias, information bias, and confounding. A more detailed description of possible biases is:
230
Prevalence and Incidence
449
In statistical epidemiology and health sciences, two essential metrics—prevalence and incidence—are fundamental for understanding disease dynamics within a population. These measures enable public health officials, epidemiologists, and researchers to assess the burden of diseases, allocate resources effectively, and design impactful public health policies and interventions.
Prevalence indicates the proportion of individuals in a population who have a specific disease or health...
Prevalence indicates the proportion of individuals in a population who have a specific disease or health...
449
Alzheimer's Disease: Treatment
177
Alzheimer's Disease (AD), a neurodegenerative disorder, is pathologically identified by amyloid plaques and neurofibrillary tangles composed of tau protein. AD pharmacotherapy aims to manage cognitive symptoms, delay disease progression, and treat behavioral symptoms. The treatment is primarily symptomatic and palliative, with no definitive disease-modifying therapy available. Cholinesterase inhibitors, including donepezil (Aricept), rivastigmine (Exelon), and galantamine (Razadyne), are...
177
Stereotypes, Prejudice, and Discrimination
90.1K
Humans are very diverse and although we share many similarities, we also have many differences. The social groups we belong to help form our identities (Tajfel, 1974). These differences may be difficult for some people to reconcile, which may lead to prejudice toward people who are different. Prejudice is a negative attitude and feeling toward an individual based solely on one’s membership in a particular social group (Allport, 1954; Brown, 2010). Prejudice is common against people who...
90.1K


