Inequalities in dementia incidence between six racial and ethnic groups over 14 years.
Inequalities in dementia incidence between six racial and ethnic groups over 14 years.
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DOI：
10.1016/j.jalz.2015.12.007
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发表时间：
2016-03
期刊：
影响因子：
--
通讯作者：
Whitmer RA
中科院分区：
文献类型：
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作者：
Mayeda ER;Glymour MM;Quesenberry CP;Whitmer RA
减少种族/民族差异是国家阿尔茨海默氏症计划（NAPA）的主要目标，但在代表美国多样性的大样本中缺乏直接比较。2000年1月1日至2013年12月31日期间274,283名64岁以上医疗保健人员的痴呆发病率和25年累积风险（n=18,778名非裔美国人，n=4,543名美洲印第安人/阿拉斯加原住民，n=21,000名拉丁裔，n=440名太平洋岛民，n=206,490名白人，n=23,032名亚裔美国人）。Cox比例风险模型根据年龄、性别、医疗使用和合并症进行调整。痴呆发病率（N=59,555）最高的是非洲裔美国人（26.6/ 1000人年）和亚洲裔美国人（22.2/ 1000人年）；拉丁美洲人（19.6/ 1000人-年）、太平洋岛民（19.6/ 1000人-年）和白人（19.3/ 1000人-年）居中；亚裔最低（15.2/ 1000人年）。非裔美国人的风险比亚裔美国人高65%（风险比=1.65；95%可信区间=1.58-1.72）。65岁时的累积25年风险为：非洲裔美国人38%，亚洲裔35%，拉丁裔32%，太平洋岛民25%，白人30%，亚裔28%。痴呆率在两组之间的差异超过60%，为NAPA减少差异的目标提供了一个全面的基准。
Reducing racial/ethnic disparities is a primary objective of the National Alzheimer’s Plan (NAPA), yet direct comparisons within large samples representing diversity of the United States are lacking. Dementia incidence from 1/1/2000-12/31/2013 and 25-year cumulative risk in 274,283 healthcare members aged 64+ (n=18,778 African-American, n=4,543 American Indian/Alaska Native (AIAN), n=21,000 Latino, n=440 Pacific Islander, n=206,490 White, n=23,032 Asian-Americans). Cox proportional hazard models were adjusted for age, sex, medical utilization, and comorbidities. Dementia incidence (N=59,555) was highest for African-Americans (26.6/1,000 person-years) and AIANs (22.2/1,000 person-years); intermediate for Latinos (19.6/1,000 person-years), Pacific Islanders (19.6/1,000 person-years), and Whites (19.3/1,000 person-years); and lowest among Asian-Americans (15.2/1,000 person-years). Risk was 65% greater for African-Americans (hazard ratio=1.65; 95% confidence interval=1.58-1.72) versus Asian-Americans. Cumulative 25-year risk at age 65 was: 38% African-Americans, 35% AIANs, 32% Latino, 25% Pacific Islanders, 30% White, and 28% Asian-Americans. Dementia rates varied over 60% between groups, providing a comprehensive benchmark for the NAPA goal of reducing disparities.