美国老年痴呆症诊断强度的区域差异:一项观察性研究
Julie P W Bynum1,2,3, Slim Benloucif1, Jonathan Martindale1
1Department of Internal Medicine, 1500 East Medical Center Dr Ann Arbor, University of Michigan Medical School, Ann Arbor, Michigan, USA.
概括
地理位置显著影响阿尔茨海默病和相关痴呆症 (ADRD) 诊断率. 诊断的强度有所不同,特别是在黑人,西班牙裔和年轻的老年人中,这会影响他们接受ADRD诊断的可能性.
科学领域:
- 老年学是一门学科.
- 公共卫生 公共卫生
- 神经学 神经学
背景情况:
- 阿尔茨海默病和相关痴呆症 (ADRD) 诊断的地理差异可能源于人口风险差异或病例识别强度的差异.
- 识别具有较低ADRD诊断强度的区域可以指导有针对性的监测工作.
研究的目的:
- 调查美国医院转诊区域 (HRRs) 的阿尔茨海默病和相关痴呆症 (ADRD) 诊断强度的地理差异.
- 为了检查诊断强度如何在不同的人口分组之间有所不同,包括种族/种族和年龄.
主要方法:
- 利用了医疗保险对HRR中一组老年人的索赔数据.
- 测量ADRD特定区域诊断强度作为预期与观察到的新ADRD病例的比率,控制人口统计,风险因素和实践强度.
主要成果:
- 在HRR中,原始的ADRD新诊断率从每100个人中从1.7到5.4不等.
- ADRD诊断强度从0.69到1.47不等,在黑人,西班牙裔和年轻 (66-74岁) 亚组中观察到的最显著的变化.
- 接受ADRD诊断的可能性的两倍差异与所有子组的诊断强度有关.
结论:
- 地理位置是接受阿尔茨海默病和相关痴呆症 (ADRD) 诊断的重要决定因素.
- 在ADRD诊断概率的差异在年轻的老年人 (66-74岁) 和少数种族/族群中尤为明显.
- 居住地影响ADRD病例识别的强度,独立于底层的人口风险因素.
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