公共卫生 公共卫生
Ibshar Khandakar1, Kai Zhang1, Leigh A Johnson1
1University of North Texas Health Science Center, Fort Worth, TX, USA.
Alzheimer's & dementia : the journal of the Alzheimer's Association
|December 23, 2025
概括
健康的社会决定因素在种族群体中对认知障碍的影响不同. 收入是所有人的关键因素,但其他社会决定因素,如教育和抑郁症得分,对于非洲裔美国人,墨西哥裔美国人和非西班牙裔白人来说的重要性各不相同.
科学领域:
- 神经科学是一个神经科学.
- 公共卫生 公共卫生
- 健康差异 在健康上的差异
背景情况:
- 健康的社会决定因素 (SDoH) 与阿尔茨海默病和相关痴呆症 (ADRD) 有关.
- 大多数研究都侧重于欧洲祖先,需要对代表性不足的人口进行研究.
- 这项研究调查了非洲裔美国人 (AA),墨西哥裔美国人 (MA) 和非西班牙裔白人 (NHW) 群体的SDoH.
研究的目的:
- 检查SDoH对不同种族/种族群体认知障碍的影响.
- 识别认知衰退的种族/种族特异性风险因素.
- 为预防ADRD提供有针对性的公共卫生干预信息.
主要方法:
- 从HABS-HD队列中对3,229名参与者进行了基于人口的观察性研究.
- 利用机器学习 (eXtreme梯度提升,随机森林) 来评估37个SDoH和风险因素.
- 采用Shapley添加式解释 (SHAP) 进行变量重要性和按种族/种族分层分析.
主要成果:
- 收入是所有群体的首要风险因素.
- 对于AA:教育,担忧 (PSWQ) 和地区贫困指数是显著的.
- 对于MA:抑郁症 (GDS),焦虑 (PSWQ) 和在美国度过的岁月是关键.
- 对于NHW:抑郁症 (GDS) 和自我报告的健康状况是最重要的.
结论:
- 在不同族群中,SDoH对认知障碍的重要性各不相同.
- 根据特定的SDoH因素确定了高风险社区.
- 支持量身定制的,以种族为特征的干预措施,将公共卫生与疾病管理结合起来,以预防ADRD.
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