权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

Dementia epidemiology, health service utilization and treatment costs among American Indian and Alaska Native Elders

美洲印第安人和阿拉斯加原住民老年人的痴呆症流行病学、卫生服务利用和治疗费用

基本信息

批准号：
9899908
负责人：
Luohua Jiang
金额：
$ 60.7万
依托单位：
UNIVERSITY OF COLORADO DENVER
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-04-01 至 2024-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9899908
关键词：
Address Adult Age Age of Onset Alaska Native Alzheimer&apos s disease related dementia American Indians Biometry Blood Vessels California Characteristics Chronic Disease Communities County Data Data Sources Dementia Diabetes Mellitus Diagnosis Disadvantaged Disease Educational Status Epidemiology Ethnic group Funding Future Gender General Population Geography Growth Health Health Policy Health Services Research Health system Healthcare Healthcare Systems Impaired cognition Incidence Individual Inequality Integrated Delivery of Health Care Investigation Knowledge Life Expectancy Location Low Income Population Medicare Mental Depression Native-Born Not Hispanic or Latino Obesity Patients Pattern Pharmaceutical Services Population Prevalence Process Public Health Reporting Research Resources Risk Risk Factors Rural Population Sampling Services Smoking Socioeconomic Status System Time Tobacco use Traumatic Brain Injury Treatment Cost Underserved Population United States Centers for Medicare and Medicaid Services United States Indian Health Service Update Ursidae Family Work aged base binge drinking cardiovascular risk factor care seeking comorbidity cost dementia risk experience health care delivery health data health disparity health service use high risk improved inpatient service insight knowledge of results member modifiable risk native elder outpatient programs racial and ethnic service delivery

项目摘要

PROJECT SUMMARY As the US population ages, the number of people living with Alzheimer’s Disease and related dementias (ADRD) is projected to triple by 2050. Although the life expectancy of American Indian and Alaska Natives (AI/ANs) is much shorter than that of other US populations, it has dramatically increased in the last few decades, with the expansion of the AI/AN elder population expected to continue. Compared to most US populations, AI/ANs bear a disproportionate burden of many established modifiable risk factors for dementia, such as diabetes, obesity, and smoking. However, our knowledge about dementia in this population remains to be severely limited. So far, only a handful of studies have examined dementia among AI/ANs, with reliable data on the prevalence or incidence of dementia in this population being nonexistent. Given so many gaps in our knowledge about dementia among AI/ANs, a systematic investigation is urgently needed to identify how problematic dementia is in this population and its impact on the Indian health system to enable more precise planning and prioritization of resources needed to support relevant health care policy. Here, leveraging on 16 years of longitudinal data available in the Indian Health Service (IHS) Data Project, a synthesis of existing IHS electronic health data for nearly 30% of the IHS service population (~ 640,000 AI/ANs), we propose to address 4 major knowledge gaps about dementia among AI/ANs as guided by the following specific aims: (1) Estimate dementia prevalence, incidence, and comorbidity rates among AI/AN elders by individual and community characteristics, such as age, gender, location, and county level socioeconomic status; (2) Characterize the association between dementia and potentially modifiable risk factors, such as diabetes, obesity, tobacco use, binge drinking, traumatic brain injuries and depression; (3) Evaluate the influence of dementia and comorbidity status on health service utilization patterns, including inpatient, outpatient, and pharmacy services; and (4) Examine the costs of providing treatment among AI/ANs with dementia, and factors that influence these costs such as comorbidity status. Our proposed analyses will provide a relatively accurate and complete picture for the epidemiology of diagnosed dementia among AI/ANs based on a large and geographically diverse sample, and contribute to the understanding of dementia and associated health service utilization in an extremely underserved population living in disadvantaged communities. Our findings promise to lay groundwork for future studies on dementia to address both the needs of AI/ANs and those of other similarly underserved populations.

项目总结