Role of Geography on Alzheimer’s Disease and Related Dementias in Central Appalachia

地理对阿巴拉契亚中部阿尔茨海默病和相关痴呆症的影响

• 批准号: 10509690
• 负责人: Jeffrey James Wing
• 金额: $ 7.4万
• 依托单位: OHIO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-15 至 2024-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10509690
• 关键词: Address; Age; Alzheimer' s Disease; Alzheimer' s disease diagnosis; Alzheimer' s disease related dementia; Alzheimer' s disease risk; American; American Medical Association; Appalachian Region; Area; Attenuated; Automobile Driving; Binomial Model; Caring; Censuses; Characteristics; Community Surveys; Country; County; Data; Data Aggregation; Data Set; Data Sources; Dementia; Detection; Diagnosis; Diagnostic; Disease; Education; Ethnic Origin; Geographic Locations; Geography; Health Services Accessibility; High Prevalence; Housing; Image; Incidence; Intervention; Investigation; Lead; Measures; Modeling; Neurologist; Ohio; Pattern; Patterns of Care; Policies; Population; Prevalence; Primary Care Physician; Principal Investigator; Proxy; Publishing; Race; Reporting; Research Personnel; Resources; Role; Rural; Rural Appalachia; Scanning; United States Centers for Medicare and Medicaid Services; Variant; Work; beneficiary; burden of illness; comorbidity; data resource; demographics; experience; geographic difference; geographic disparity; health care quality; health care service; improved; innovation; multiple data sources; prognostic; programs; racial and ethnic; regional difference; rural area; rural counties; rural dwellers; sociodemographic factors; sociodemographics; urban area

Project Summary/Abstract Geographic variation in Alzheimer’s disease and related dementias (ADRD) prevalence exists, but the mechanisms driving these disparities remain unknown. The two most likely and non-exclusive explanations for geographic variation in ADRD are: 1. disparities in patterning of sociodemographic factors (e.g. rural residents may be at a greater risk of ADRD due to lower educational attainment) and/or 2. differences in disease detection rates (e.g. rural residents may have reduced access to and quality of health care services and thus fewer dementia diagnoses regardless of the true prevalence). As rural areas have lower reported ADRD prevalence compared to urban areas in spite of lower educational attainment (which should lead to higher ADRD prevalence) this argues that the true burden of ADRD in likely underestimated in areas without adequate detection resources. There is need to understand if ADRD prevalence is truly lower in rural areas, or if this is a disease detection difference. The objective of this proposal is to assess the burden of ADRD in Central Appalachia. By using geographic characteristics to assess the association between geographic variation, socio-demographic factors, and access to care (e.g. primary care physicians (PCPs), neurologists) we will understand how patterns of care influence ADRD diagnoses and which parts of the country may have relatively over- or underestimated ADRD prevalence due to differences in care intensity. 1. We will verify regional differences in ADRD prevalence across the Central Appalachian region using stratified negative binomial regression models. Working hypothesis: Rural counties will have lower ADRD prevalence, as will Appalachian counties relative to urban and non-Appalachian counties, respectively. 2. Socio-demographic and access to care factors will be included in existing negative binomial models to assess their contribution to regional differences in ADRD prevalence. Working hypothesis: socio-demographic and access factors partially explain/attenuate variations in ADRD prevalence. This proposal addresses the objectives of PAS-19-391 in several ways: 1. The Principal Investigator (PI) is an early stage investigator committed to ADRD; 2. The PI has experience with using CMS data, census data, and other existing aggregate data sources; and 3. The PI has published using these data in describing geographic differences in ADRD prevalence in Ohio. This project would represent the next step in better understanding of regional differences in ADRD prevalence and provide critical data toward the role of access to care in estimating ADRD prevalence.

项目总结/文摘