Incidence of AD in African-Americans, Caribbean Hispanics, and Caucasians in northern Manhattan
Incidence of AD in African-Americans, Caribbean Hispanics, and Caucasians in northern Manhattan
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DOI：
10.1212/wnl.56.1.49
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发表时间：
2001-01-09
期刊：
影响因子：
9.9
通讯作者：
Mayeux, R
中科院分区：
文献类型：
--
作者：
Tang, MX;Cross, P;Mayeux, R
目的：比较老年非裔美国人、加勒比拉美裔人和白人中AD的发病率，并确定是否同时发生的脑血管疾病导致不同种族之间报告的差异不一致。方法：这是一项在纽约市华盛顿高地和因伍德社区进行的为期7年的以人群为基础的纵向研究。计算AD的年发病率，并按种族分组进行比较，并计算经教育、糖尿病、心血管危险因素和中风的差异调整后的累积发病率。结果：65~74岁年龄段AD发病率为1.3%(95%CI，0.8~1.7)/人年，75~84岁年龄段AD发病率为4.0%(95%CI，3.2~4.8)/年，85岁及以上人群年发病率为7.9%(95%CI，5.5~10.5)/年。与白人相比，非洲裔美国人和加勒比拉美裔人至90岁的AD累积发病率增加了两倍。调整了受教育年限、文盲或中风、高血压、心脏病或糖尿病病史的差异，并没有改变三个民族之间不成比例的风险。结论：非裔美国人和加勒比拉美裔老年人的远期阿尔茨海默病的发病率明显高于白人。临床上明显的心血管或脑血管疾病的存在并不会增加疾病的风险。由于美国65岁及以上的非裔美国人和加勒比裔拉美裔人的比例比白人的比例增长得更快，因此必须了解老年人之间的健康差距。
Objective: To compare the incidence rates for AD among elderly African-American, Caribbean Hispanic, and white individuals and to determine whether coincident cerebrovascular disease contributes to the inconsistency in reported differences among ethnic groups, Methods: This was a population-based, longitudinal study over a 7-year period in the Washington Heights and Inwood communities of New York City. Annual incidence rates for AD were calculated and compared by ethnic group, and cumulative incidence adjusted for differences in education, diabetes, cardiovascular risk factors, and stroke was calculated. Results: The age-specific incidence rate for probable and possible AD was 1.3% (95% CI, 0.8 to 1.7) per person-year between the ages of 65 and 74 years, 4.0% (95% CI, 3.2 to 4.8) per person-year between ages 75 and 84 years, and 7.9% (95% CI, 5.5 to 10.5) per person-year for ages 85 and older. Compared to white individuals, the cumulative incidence of AD to age 90 years was increased twofold among African-American and Caribbean Hispanic individuals. Adjustment for differences in number of years of education, illiteracy, or a history of stroke, hypertension, heart disease, or diabetes did not change the disproportionate risks among the three ethnic groups. Conclusion: The incidence rate far AD was significantly higher among African-American and Caribbean Hispanic elderly individuals compared white individuals. The presence of clinically apparent cardiovascular or cerebrovascular disease did not contribute to the increased risk of disease. Because the proportion of African-American and Caribbean Hispanic individuals reaching ages 65 and older in the United States is increasing more rapidly than the proportion of white individuals, it is imperative that this disparity in health among the elderly be understood.