美国退伍军人中痴呆症发病率的区域差异
Christina S Dintica1, Amber L Bahorik1, Feng Xia2
1Department of Psychiatry and Behavioral Sciences, University of California, San Francisco.
JAMA neurology
|June 9, 2025
概括
美国各地区的痴呆症发病率差异很大,东南地区的发病率最高,大西洋中部地区的发病率最低. 这些地理差异凸显了有针对性的公共卫生战略和医疗保健规划的必要性.
科学领域:
- 老年学是一门学科.
- 流行病学 流行病学
- 公共卫生 公共卫生
背景情况:
- 美国以前的痴呆发病率研究缺乏区域特异性,掩盖了地理差异和潜在的促成因素.
- 了解痴呆症发病率的区域差异对于有效的公共卫生干预和医疗保健资源分配至关重要.
研究的目的:
- 在美国退伍军人卫生管理局 (VHA) 系统中调查老年人痴呆症发病率的地理差异.
- 确定美国特定地区的痴呆发病率较高或较低.
主要方法:
- 一项队列研究分析了1999年10月至2021年9月65岁以上的1,268,599名没有痴呆症的退伍军人的数据.
- 痴呆症发病率是根据美国疾病预防控制中心 (CDC) 定义的10个地区的邮政编码每1000人/年计算的.
- 普森回归模型评估了发病率比率的区域差异,并调整了诸如年龄,性别,农村和心血管相关疾病等共变量.
主要成果:
- 每1000人年痴呆发病率在中大西洋地区 (11.2) 最低,在东南地区 (14.0) 最高.
- 与大西洋中部地区相比,东南地区 (RR,1.25),西北地区 (RR,1.23) 和落基山脉 (RR,1.23) 的人口调整后的发病率最高.
- 这些区域差异在调整农村地区,心血管相关疾病和相应死亡风险后仍然存在.
结论:
- 在美国老年退伍军人中,痴呆症发病率存在显著的地理差异,独立于关键的人口和健康因素.
- 这些研究结果强调了需要量身定制的医疗保健规划,有针对性的公共卫生倡议,以及明智的政策制定,以解决区域性痴呆症差异.
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