Place of birth,age of immigration,and disability in Hispanics with multiple sclerosis.
Place of birth,age of immigration,and disability in Hispanics with multiple sclerosis.
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DOI：
10.1016/j.msard.2014.11.008
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发表时间：
2015-01
影响因子：
4
通讯作者：
Langer-Gould, Annette M.
中科院分区：
文献类型：
--
作者：
Amezcua, Lilyana;Conti, David V.;Liu, Lihua;Ledezma, Karina;Langer-Gould, Annette M.
在美国，西班牙裔是一个多元化的群体，他们的知识和患多发性硬化症（MS）的风险可能与他们的文化适应水平有关。通过出生地和移民年龄比较美国西班牙裔与多发性硬化症的致残风险。我们对居住在南加州的304名西班牙裔多发性硬化症患者进行了横断面研究。出生地点和移民年龄被用作文化适应的替代指标。个体被分为美国出生、早期和晚期移民（分别为移民美国<15年和≥15年）。残障风险（扩展残障状态量表≥6）根据症状出现时的年龄、性别、社会经济地位和疾病持续时间进行调整，采用logistic回归。晚移民在症状出现时年龄较大（34.2±11.9岁vs. 31.9±12.9岁vs. 28.5±10.2岁，p<0.001），与早移民和美国出生者相比，有更多的残疾（28% vs. 9% vs. 18%, p=0.04）。在女性性别、多发性硬化症类型、种族、慢性疾病和疾病持续时间方面，各组之间没有差异，但在社会经济地位方面存在差异。与美国出生的人相比，晚移民与残疾增加独立相关（调整OR为2.2,95% CIs1.04-4.74; p=0.04）。后来移民到美国的拉美裔多发性硬化症患者的残疾程度更高。这些调查结果可能反映了社会、环境和文化因素的差异，这些因素可能成为获得和利用保健服务的障碍。对这一人群对多发性硬化症的看法和态度进行深入评估是必要的。
Hispanics in the US are a diverse community where their knowledge and risk for developing disability in multiple sclerosis (MS) may relate to their level of acculturation. To compare the risk of disability in Hispanics with MS in the US by place of birth and age of immigration. We conducted a cross-sectional study of 304 Hispanics with MS residing in Southern California. Place of birth and age of immigration were used as proxies to acculturation. Individuals were classified as US-born, early and late-immigrant (<15 and ≥15 years at immigration to the US, respectively). Risk of disability (expanded disability status scale ≥6) was adjusted for age at symptom onset, sex, socioeconomic status, and disease duration, using logistic regression. Late-immigrants were older at symptom onset (34.2±11.9 vs. 31.9±12.9 vs. 28.5±10.2 years, p<0.001) and had more disability (28% vs. 9% vs. 18%, p=0.04) compared to early-immigrant and US-born respectively. There was no difference between groups by female sex, type of MS, ethnicity, chronic medical conditions, and disease duration while differences were noted by socioeconomic status. Being late-immigrant was independently associated with increased disability (adjusted OR 2.2, 95% CIs1.04-4.74; p=0.04) compared to US-born. Later immigration to the US in Hispanics with MS is associated with greater disability. These findings may reflect differences in social, environmental and cultural factors that may act as barriers for accessibility and utilization of health services. An in-depth assessment of the perceptions and attitudes about MS are warranted in this population.
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影响因子：
5.1
作者：
Berg-Hansen, P.;Smestad, C.;Celius, E. G.
通讯作者：
Celius, E. G.
影响因子：
5.1
作者：
Fu, Steven S.;Burgess, Diana;Joseph, Anne M.
通讯作者：
Joseph, Anne M.
影响因子：
5.8
作者：
Amezcua, L.;Lund, B. T.;Islam, T.
通讯作者：
Islam, T.
影响因子：
9.9
作者：
Langer-Gould, Annette;Brara, Sonu M.;Zhang, Jian L.
通讯作者：
Zhang, Jian L.
影响因子：
6
作者：
McLeod, J. G.;Hammond, S. R.;Kurtzke, J. F.
通讯作者：
Kurtzke, J. F.