The effect of race and co-morbidities on Alzheimer's disease based on Medicare data.
The effect of race and co-morbidities on Alzheimer's disease based on Medicare data.
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基于医疗保险数据的种族和合并症对阿尔茨海默病的影响。
DOI：
10.1002/alz.12838
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Wharton,Whitney
中科院分区：
文献类型：
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作者：
Steenland,Kyle;Tan,Youran;Wingo,Thomas;Shi,Liuhua;Xiao,Siyao;Wharton,Whitney
IntroductionAlzheimer病（AD）的发病率被认为是黑人高于白色individual.MethodsWe研究了美国医疗保险人口从2000年到2018年。考克斯回归被用来确定种族和共病AD incidence.ResultsWe研究了11，880，906医疗保险受益人，与774，548 AD病例的作用。合并症数量增加（1-7）的风险比（HR）为1.51、2.00、2.55、3.16、2.89、4.77和5.65。在没有合并症的患者中，黑人患者的发生率低于白色患者（HR = 0.69），而在有一种以上合并症的患者中，黑人患者的发生率较高（HR = 1.19）。对于白色个体，高血压的存在使AD发病率增加14%，但是对于那些是Black.DiscussionMore的共病与较高的AD发病率强烈相关的个体，高血压使AD发病率增加69%。黑人与白色人相比，只有那些患有共病的人的发病率更高，这似乎是由更多的共病和高血压的更大影响所驱动的。重点黑人已被证明比白色人有更高的阿尔茨海默病（AD）发病率。已知一些共病会增加AD风险。在没有共病的医疗保险数据中，黑人比白色人的风险更低。在患有共病的人群中，黑人比白色人的患病率更高。高血压导致黑人比白色人的AD风险增加更大。
IntroductionAlzheimer's disease (AD) incidence is thought to be higher among Black than White individuals.MethodsWe studied the US Medicare population from 2000 to 2018. Cox regression was used to determine the roles of race and co‐morbidities for AD incidence.ResultsWe studied 11,880,906 Medicare beneficiaries, with 774,548 AD cases. Hazard ratios (HRs) by increasing numbers of co‐morbidities (1–7) were 1.51, 2.00, 2.55, 3.16, 2.89, 4.77, and 5.65. Among those with no co‐morbidities, Black individuals had a lower rate than those who are White (HR = 0.69), while among those with one more co‐morbidities, Black individuals had a higher rate (HR = 1.19). The presence of hypertension increased AD rates by 14% for White individuals, but 69% for those who are Black.DiscussionMore co‐morbidities was strongly associated with higher AD rates. The higher rates for Black versus White individuals was apparent only for those with co‐morbidities and appears driven both by more co‐morbidities, and the greater effect of hypertension.HighlightsBlack individuals have been shown to have higher Alzheimer's disease (AD) rates than those who are White.Some co‐morbidities are known to increase AD risk.Among those In Medicare data with no co‐morbidities, Black individuals have less risk than those who are White.Among those with co‐morbidities, Black individuals have higher rates than those who are White.Hypertension results in a much stronger increase in AD risk for Black versus White individuals.