A Meta-Analysis of Alzheimer's Disease Incidence and Prevalence Comparing African-Americans and Caucasians.
A Meta-Analysis of Alzheimer's Disease Incidence and Prevalence Comparing African-Americans and Caucasians.
复制标题
DOI：
10.3233/jad-150778
复制
发表时间：
2016
期刊：
影响因子：
--
通讯作者：
Wharton W
中科院分区：
文献类型：
--
作者：
Steenland K;Goldstein FC;Levey A;Wharton W
几项研究表明，非裔美国人（AAs）的阿尔茨海默病（AD）发病率高于白人（CC）。如果这一发现是一致的研究，它提出了重要的病因学问题的因素负责这种差异。它还影响了美国未来可能的AD公共卫生负担，因为非高加索人群成为大多数。估计所有可用研究中AD发生率的AA/CC比率。在从文献中识别出6项相关研究后，我们对基于人群的研究进行了一项荟萃分析，以确定AA与CC的AD发病率比（RR）。我们使用逆方差加权计算了所有研究的AA/CC比率，并评估了研究间的异质性。利用这些发病率数据，以及诊断后生存率和全因死亡率数据，我们还估计了美国AA和CC中AD的患病率。有6项基于人群的研究比较了AA和CC之间的AD发病率，估计有370例AA和640例CC事件病例。荟萃分析RR显示AA的AD率比CC高64%（RR = 1.64（95%CI 1.35-2.00）），无异质性证据。我们估计，目前美国65-90岁年龄组的AD患病率为5.5%（CC）和8.6%（AA）（患病率比1.56）。与CC相比，AA的AD事件和流行风险增加，原因未知，但假设反映了生物学，心理学和社会经济因素。
Several studies have shown higher Alzheimer’s disease (AD) incidence rates are in African-Americans (AAs) than Caucasians (CCs). If this finding is consistent across studies, it raises important etiologic questions regarding factors responsible for this discrepancy. It also affects the likely public health burden of AD in the US in the future, as the non-Caucasian population becomes the majority. Estimate the AA/CC rate ratio for AD incidence across all available studies. We conducted a meta-analysis of population-based studies for the rate ratio (RR) of AD incidence for AAs versus CCs, after identifying six relevant studies from the literature. We calculated an AA/CC rate ratio across all studies using inverse-variance weighting, and assessed inter-study heterogeneity. Using these incidence data, as well as data on survival after diagnosis, and on all-cause mortality, we also estimated the US prevalence of AD among AAs and CCs. There were six population-based studies with data comparing AD incidence between AAs and CCs, with an estimated 370 AA and 640 CC incident cases. The meta-analysis RR showed that the AD rate for AAs was 64% higher than for CCs (RR = 1.64 (95% CI 1.35–2.00)), with no evidence of heterogeneity. We estimated the current US AD prevalence for ages 65–90 to be 5.5% for CCs, and 8.6% for AAs (prevalence ratio 1.56). AAs have an increased risk of incident and prevalent AD compared to CCs for reasons which are unknown, but are hypothesized to reflect biological, psychological, and socioeconomic factors.