Health Disparities in Dementia.
Health Disparities in Dementia.
复制标题
痴呆症的健康差异。
DOI：
10.1212/con.0000000000001088
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发表时间：
2022-06-01
期刊：
影响因子：
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通讯作者：
Babulal, Ganesh M
中科院分区：
文献类型：
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作者：
Balls-Berry, Joyce Joy E;Babulal, Ganesh M
在美国，阿尔茨海默病和相关痴呆（ADRD）的健康差异的原因是多因素的。这篇文章将健康差异与ADRD的神经退行性过程联系起来。老年人的预期寿命增加了，65岁的人预期寿命为19年或更长，85岁的人预期寿命平均延长6至7年。与非西班牙裔/拉丁裔白色人相比，某些种族群体（黑人、西班牙裔/拉丁裔、美洲印第安人/阿拉斯加原住民和夏威夷原住民/太平洋岛民）的个体发生ADRD的风险可能更高。尽管随着时间的推移，认知能力下降的比率没有统计学显著差异，但不同民族之间ADRD风险较高的差异仍然存在。健康的社会决定因素、遭受歧视和压迫的经历以及获得护理的机会的交叉性与司法问题以及ADRD的风险和表现有关。各种健康差异的理论框架提供了有组织的方法来跟踪不同患者的健康差异的进展。ADRD的健康差异是复杂的。神经科医生及其护理团队必须考虑对少数民族成员进行临床ADRD评估的主要原因，以及可能影响患者依从性和诊断和管理建议依从性的因素。
Causes of health disparities in Alzheimer disease and related dementias (ADRD) in the United States are multifactorial. This article contextualizes health disparities as they relate to the neurodegenerative processes of ADRD. Older adults’ life expectancy has increased such that a 65-year-old is expected to live 19 or more years and an 85-year-old can expect to live, on average, 6 to 7 years longer. Individuals of certain ethnoracial groups (Black, Hispanic/Latino, American Indian/Alaska Native, and Native Hawaiian/Pacific Islander) may be at a higher risk of incident ADRD compared to non-Hispanic/Latino White people. These differences in a higher risk of ADRD across ethnoracial groups persist despite no statistically significant differences in the rate of cognitive decline over time. The intersectionality of social determinants of health, experiences with discrimination and oppression, and access to care are related to the issue of justice and the risk for and expression of ADRD. The theoretical frameworks of various health disparities provide organized approaches to tracking the progression of health disparities for diverse patients. ADRD health disparities are complex. Neurologists and their care teams must consider the main reasons for clinical ADRD evaluations of members of ethnoracial groups and the factors that may impact patient adherence and compliance with diagnostic and management recommendations.