Regional variation in U.S dementia trends from 2000-2012.
Regional variation in U.S dementia trends from 2000-2012.
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DOI：
10.1016/j.ssmph.2022.101164
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发表时间：
2022-09
影响因子：
4.7
通讯作者：
Fisk, Calley E.
中科院分区：
文献类型：
--
作者：
Ailshire, Jennifer A.;Walsemann, Katrina M.;Fisk, Calley E.
尽管最近的研究报告称，美国老年人的痴呆症患病率有所下降，但国家趋势可能掩盖了国家以下地区的差异，特别是考虑到与地理有关的巨大健康和社会不平等。为了解决这一差距，我们确定了报告的国家痴呆症趋势是否存在次国家差异，以及区域特定趋势是否可以用社会人口统计学和健康特征来解释。数据来自2000年（n = 10,447）和2012年（10,426）的健康与退休研究浪潮。我们使用了经过验证的方法，使用代理和自我应答者进行痴呆分类。随着时间的推移调整了人内聚类的逻辑回归模型，按地区和人口普查部门估计了痴呆症患病率的趋势。我们发现2000年和2012年痴呆患病率的次国家差异，以及这一时期痴呆患病率的变化。2000年，痴呆症患病率最低的是西部（8.6%），中西部（10.0%）和东北部（11.1%）较高，南部最高（14.6%）。从2000年到2012年，美国所有地区的痴呆症患病率随着时间的推移而下降，但与其他地区（7.0-7.8%）相比，南部的痴呆症患病率最高（10.7%）。尽管美国的痴呆症发病率呈下降趋势，但2012年南部地区的痴呆症患病率与2000年其他地区的水平相近。与其他地区相比，随着时间的推移，西方的变化相对较小，但2000年西方的痴呆症患病率已经相当低。在区域内，2000年至2012年期间痴呆症患病率的趋势在各普查区划之间也略有不同。全国各地痴呆患病率变化的差异在很大程度上可以用教育和健康状况来解释。基线患病率的变化以及不同的变化率突出了检查国家以下痴呆趋势变化的重要性。痴呆症患病率在国家层面有所下降，但各地区之间存在关键差异。尽管痴呆症的患病率在美国所有地区都有所下降，但在南部仍是最高的。西方的痴呆症患病率变化不大，可能是因为患病率本来就很低。痴呆症流行趋势的地区差异在很大程度上可以用教育程度来解释。
Although recent studies report a decline in dementia prevalence among U.S. older adults, national trends may mask subnational variation, particularly given large health and social inequalities linked to geography. To address this gap, we determined if there was subnational variation in reported national dementia trends and if region-specific trends were explained by sociodemographic and health characteristics. Data come from the 2000 (n = 10,447) and 2012 (10,426) waves of the Health and Retirement Study. We used validated methods for dementia classification using proxy and self-respondents. Logistic regression models, adjusted for within-person clustering over time, estimated trends in dementia prevalence by region and census division. We found subnational variation in dementia prevalence in both 2000 and 2012, as well as in change in dementia prevalence during this period. In 2000, dementia prevalence was lowest in the West (8.6%), higher in the Midwest (10.0%) and Northeast (11.1%), and highest in the South (14.6%). Dementia prevalence declined over time across all regions of the U.S. from 2000 to 2012 but remained highest in the South (10.7%) compared to the other regions (7.0–7.8%). Despite downward trends in dementia across the U.S., the prevalence of dementia in the South in 2012 approximated levels found in other regions in 2000. There was relatively less change over time in the West compared to other regions, but dementia prevalence was already quite low in the West in 2000. Within region, trends in dementia prevalence between 2000 and 2012 also varied slightly across census divisions. Subnational variation in changes in dementia prevalence were largely explained by education and health status. Variation in baseline prevalence, as well as differential rates of change, highlight the importance of examining subnational variation in dementia trends. Dementia prevalence has declined at the national level, but there are key differences by region. Although dementia prevalence declined across all U.S. regions, it remained highest in the South. Dementia prevalence changed little in the West, likely because prevalence was already low. Regional differences in trends in dementia prevalence were largely explained by educational attainment.
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DOI：
10.1016/j.trci.2018.08.009
发表时间：
2018
期刊：
Alzheimer's & dementia (New York, N. Y.)
影响因子：
--
作者：
Chen C;Zissimopoulos JM
通讯作者：
Zissimopoulos JM
影响因子：
14
作者：
Langa, Kenneth M.;Larson, Eric B.;Rosen, Allison B.
通讯作者：
Rosen, Allison B.
影响因子：
3.5
作者：
Montez, Jennifer Karas;Zajacova, Anna;Beckfield, Jason
通讯作者：
Beckfield, Jason
影响因子：
4.7
作者：
Hale, Jo Mhairi;Schneider, Daniel C.;Myrskyla, Mikko
通讯作者：
Myrskyla, Mikko
影响因子：
7.2
作者：
Agüero-Torres, H;von Strauss, E;Fratiglioni, L
通讯作者：
Fratiglioni, L