加快认知衰退中的不平等:使用嵌套非线性回归解决观察窗口偏差
Sean A P Clouston1,2, Douglas W Hanes1, Dylan M Smith1,2
1Program in Public Health, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, USA.
概括
解决阿尔茨海默病和相关痴呆症 (ADRD) 研究中的观察窗口偏差揭示了显著的社会不平等. 教育差异和种族影响加速认知衰退的开始,突出了ADRD风险的不平等.
科学领域:
- 神经科学是一个神经科学.
- 公共卫生 公共卫生
- 社会学 社会学 社会学
背景情况:
- 观察窗口偏差使对阿尔茨海默病和相关痴呆症 (ADRD) 风险的教育差异的研究复杂化.
- 之前的研究已经产生了相互矛盾的结果,因为在观察加速认知衰退之前的时期有局限性.
研究的目的:
- 在ADRD研究中引入一种解决观察窗口偏差的新型模型.
- 调查ADRD的加速认知衰退中的差异存在和起源.
主要方法:
- 利用了来自32,441名健康与退休研究参与者的167,314个认知评估的大数据集.
- 实现了一个参数非线性嵌套纵向回归模型.
- 报告的多变量调整的节点发病率 (aNIR) 以量化风险.
主要成果:
- 大学学位与加速认知衰退的发病率降低了74.7% (aNIR = 0.253,p < 0.001).
- 黑人参与者表现出99.5%更高的加速认知衰退发病率 (aNIR = 1.995,p < 0.001),即使经过对共变量进行调整.
- 性别分层分析显示,女性受教育收益减少,少数群体女性的发病率增加.
结论:
- 这种新的方法有效地减轻了观察窗口的偏差,揭示了ADRD发病的重大社会不平等.
- 结果表明,在ADRD临床前阶段,教育和种族/种族差异显著.
- 这项研究强调了性/性别与种族和教育在ADRD差异中的交叉性.
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