Ethnic disparities in the uptake of anti-dementia medication in young and late-onset dementia
Ethnic disparities in the uptake of anti-dementia medication in young and late-onset dementia
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DOI：
10.1017/s1041610220000794
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发表时间：
2023-07-01
影响因子：
7
通讯作者：
Komuravelli, Aravind
中科院分区：
文献类型：
--
作者：
Giebel, Clarissa;Cations, Monica;Komuravelli, Aravind
目的：痴呆症患者在诊断后试图获得护理时可能会面临障碍，特别是在老年痴呆症（YOD）中。关于种族对抗痴呆症药物使用的影响以及年龄组之间的差异知之甚少。本研究的目的是分析YOD和晚发性痴呆（LOD）患者之间抗痴呆药物摄入变化的国家数据。设计：横断面纵向队列研究。设置：数据来自美国国家阿尔茨海默病协调中心，时间为2005年9月至2019年3月。参与者：包括首次就诊的阿尔茨海默病（AD）痴呆、路易体痴呆（LBD）和帕金森病痴呆（PDD）患者。测量：采用Logistic回归分析受教育程度和种族对胆碱酯酶抑制剂和美金刚使用的影响，解释YOD/LOD、性别、生活状况、严重程度、结果：总共有15，742名AD痴呆和LBD/PDD患者被纳入，其中11，019名PwD完成了首次随访。YOD患者使用美金刚的人数明显多于LOD患者，而使用胆碱酯酶抑制剂的人数较少。来自少数民族背景的PwD使用美金刚和胆碱酯酶抑制剂的频率低于来自白色民族背景的PwD。Logistic回归分析表明，种族是一个显着的决定因素，美金刚胺和胆碱酯酶抑制剂的使用，而教育只是一个显着的决定因素，为memantine usage.Conclusions：研究结果强调社会因素的影响，目前使用的抗痴呆药物和需要更多的资源，使公平使用抗痴呆药物。
Objectives:People with dementia can face barriers when trying to access care after a diagnosis, particularly in young-onset dementia (YOD). Little is known about the effects of ethnicity on the use of anti-dementia medication and variations between age groups. The aim of this study was to analyze national data on variations in the uptake of anti-dementia medication between people with YOD and late-onset dementia (LOD).Design:Cross-sectional longitudinal cohort study.Setting:Data from the U.S. National Alzheimer's Coordinating Centre were obtained from September 2005 to March 2019.Participants:First visits of people with a diagnosis of Alzheimer's disease (AD) dementia, Lewy body dementia (LBD), and Parkinson's disease dementia (PDD) were included.Measurements:Logistic regression was used to analyze the effects of education and ethnicity on use of cholinesterase inhibitors and memantine, accounting for YOD/LOD, gender, living situation, severity stage, and comorbidities.Results:In total, 15,742 people with AD dementia and LBD/PDD were included, with 11,019 PwD having completed a first follow-up visit. Significantly more people with YOD used memantine than those with LOD, while fewer used cholinesterase inhibitors. PwD from minority ethnic backgrounds used memantine and cholinesterase inhibitors less often than those from a White ethnic background. Logistic regression analysis showed that ethnicity was a significant determinant of both memantine and cholinesterase inhibitors usage, while education was only a significant determinant for memantine usage.Conclusions:Findings highlight the impact of social factors on current usage of anti-dementia medication and the need for more resources to enable equitable use of anti-dementia medication.