Racial/Ethnic Disparities in Length of Life after Dementia Diagnosis: an 18-Year Follow-up Study of Medicare Beneficiaries.
Racial/Ethnic Disparities in Length of Life after Dementia Diagnosis: an 18-Year Follow-up Study of Medicare Beneficiaries.
复制标题
痴呆症诊断后寿命的种族/民族差异：医疗保险受益人 18 年随访研究。
DOI：
10.1016/j.lana.2021.100179
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Zissimopoulos,JulieM
中科院分区：
文献类型：
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作者：
Chen,Yi;Crimmins,Eileen;Ferido,Patricia;Zissimopoulos,JulieM
BackgroundThis study quantified survival time after dementia diagnosis and assessments mechanisms driving differences across race/ethnic to inform care and financial planning.MethodsUsing 100% Medicare claims data，we identified 670，955 beneficiaries with incident dementia diagnosis in 2001 and follow them through 2018.我们量化了诊断后生存率的种族/民族差异，以及按性别、诊断时年龄、社会经济地位和地理位置定义的亚组。此外，我们调查了2001- 2013年8，080，098名痴呆症患者的5年死亡风险的种族/民族时间趋势。美国印第安人/阿拉斯加原住民和白人之间没有区别。在性别、诊断年龄和城市/农村亚组中，种族/民族差异的大小相似;然而，在低收入受益人中，非白人和白人之间的生存优势更大。黑人死亡率的州差异与南方的差异一致，但与亚洲人和西班牙裔人的差异不一致。2001年至2013年，亚裔白人和西班牙裔白人的死亡率差异有所下降。解释痴呆症诊断后的种族/族裔生存差异对痴呆症对个人和家庭的经济影响程度有影响。随着时间的推移，量化生存差异和变化通知家庭，社区和社会层面的长期护理规划的一个大的和不断增长的人口与痴呆症患者。经济地位和地理位置的种族/民族差异的大小变化为有针对性的策略提供了机会，以减少经济后果，改善痴呆症诊断后的护理和生活质量。
BackgroundThis study quantifies survival time after dementia diagnosis and assesses mechanisms driving differences across race/ethnicity to inform care and financial planning.MethodsUsing 100% Medicare claims data, we identified 670,955 beneficiaries with incident dementia diagnosis in 2001 and followed them through 2018. We quantified racial/ethnic differences in post-diagnosis survival and for subgroups defined by sex, age at diagnosis, socio-economic status, and geography. Additionally, we investigated racial/ethnic time trends in 5-year mortality risk of 8,080,098 beneficiaries with incident dementia in years 2001-2013.FindingsHispanics and Asians diagnosed with dementia had 40% lower mortality risk and African Americans had 13% lower mortality risk than Whites. There was no difference between American Indians/Alaska Natives and Whites. Racial/ethnic differences were of similar size in sex, age at diagnosis, and urban/rural subgroups; however, the survival advantage between non-Whites and Whites was larger among low-income beneficiaries. State differences in mortality among Blacks were consistent with a Southern divide but not for Asians and Hispanics. The Asian-White and Hispanic-White mortality differences decreased 2001 to 2013.InterpretationRacial/ethnic survival differences after dementia diagnosis have implications for magnitude of financial impact of dementia on individuals and families. Quantifying survival differences and changes over time informs family, community, and societal level long-term care planning for a large and growing population of persons living with dementia. Variation in the size of racial/ethnic differences by economic status and geographic location provides opportunities for targeted strategies to reduce economic consequences and improve care and quality of life after dementia diagnosis.FundingNational Institutes of Health (R01AG055401, P30AG066589).