Trends in prevalence, health disparities, and early detection of dementia: A 10-year nationally representative serial cross-sectional and cohort study.
Trends in prevalence, health disparities, and early detection of dementia: A 10-year nationally representative serial cross-sectional and cohort study.
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DOI：
10.3389/fpubh.2022.1021010
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发表时间：
2022
影响因子：
5.2
通讯作者：
Friedman, Daniela B. B.
中科院分区：
文献类型：
--
作者：
Lu, Kevin;Xiong, Xiaomo;Li, Minghui;Yuan, Jing;Luo, Ye;Friedman, Daniela B. B.
关键词：
确定美国中老年人轻度认知障碍（MCI）和痴呆的流行趋势，并确定与早期发现痴呆相关的危险因素。我们使用了健康与退休研究（HRS）（2006-2016）的10年全国代表性纵向数据。年龄在55岁及以上的成年人被纳入调查，以研究这一趋势。为了确定相关因素，纳入了2006年55岁及以上的成年人，他们在随后的浪潮中发展为轻度认知障碍或痴呆，直到2016年的浪潮。使用认知功能的Langa-Weir分类来确定痴呆症的早期和晚期检测。使用多变量logistic回归模型来确定与早期发现痴呆相关的因素。在6年的调查中，分析MCI和痴呆症患病率的样本量从14,935到16,115不等，并确定了3,729个人，以确定早期发现痴呆症的相关因素。其中，65岁及以上的参与者占77.9%，男性参与者占37.2%。MCI和痴呆的10年患病率分别为14.5%和6.6%。我们还发现，在过去十年中，MCI（从14.9%降至13.6%）和痴呆（从7.4%降至6.0%）的患病率总体呈下降趋势。使用logistic回归控制年份，非西班牙裔黑人（MCI: OR = 2.83, P < 0.001；痴呆：OR = 2.53, P < 0.001）和西班牙裔（MCI: OR = 2.52, P < 0.001；痴呆：OR = 2.62, P < 0.001）的MCI和痴呆患病率均高于非西班牙裔白人参与者。此外，男性的MCI患病率（OR = 0.94, P = 0.035）和痴呆患病率（OR = 0.84, P < 0.001）低于女性。早期发现痴呆的相关因素包括年龄、性别、种族、受教育程度、中风、关节炎疾病、心脏病和养老金。该研究发现，在过去十年中，美国中老年人的轻度认知障碍和痴呆患病率呈下降趋势，并存在种族/民族和性别差异。可能需要制定保健政策和战略，以解决患病率方面的健康差异，并在临床环境中考虑到早期发现痴呆症的相关因素。
To identify trends in the prevalence of mild cognitive impairment (MCI) and dementia, and to determine risk factors associated with the early detection of dementia among U.S. middle-aged and older adults. We used 10-year nationally representative longitudinal data from the Health and Retirement Study (HRS) (2006–2016). Adults aged 55 years or older were included to examine the trend. To identify the associated factors, adults aged 55 years or older in 2006 who developed MCI or dementia in subsequent waves until the 2016 wave were included. Early and late detection of dementia were identified using the Langa-Weir classification of cognitive function. Multivariate logistic regression models were used to identify factors associated with the early detection of dementia. The sample size for the analysis of the prevalence of MCI and dementia ranged from 14,935 to 16,115 in the six survey years, and 3,729 individuals were identified to determine associated factors of the early detection of dementia. Among them, participants aged 65 years or older accounted for 77.9%, and male participants accounted for 37.2%. The 10-year prevalence of MCI and dementia was 14.5 and 6.6%, respectively. We also found decreasing prevalence trends in MCI (from 14.9 to 13.6%) and dementia (from 7.4 to 6.0%) overall in the past decade. Using logistic regression controlling for the year, non-Hispanic black (MCI: OR = 2.83, P < 0.001; dementia: OR = 2.53, P < 0.001) and Hispanic (MCI: OR = 2.52, P < 0.001; dementia: OR = 2.62, P < 0.001) had a higher prevalence of both MCI and dementia than non-Hispanic white participants. In addition, men had a lower prevalence of MCI (OR = 0.94, P = 0.035) and dementia (OR = 0.84, P < 0.001) compared to women. Associated factors of the early detection of dementia include age, gender, race, educational attainment, stroke, arthritis diseases, heart problems, and pensions. This study found a decreasing trend in the prevalence of MCI and dementia in the past decade and associated racial/ethnic and gender disparities among U.S. middle-aged and older adults. Healthcare policies and strategies may be needed to address health disparities in the prevalence and take the associated factors of the early detection of dementia into account in clinical settings.
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