Dementia Mortality in the United States, 1999–2016

Kramarow, Ellen A.; Tejada-Vera, Betzaida

doi:10.1093/geroni/igy023.912

Cited by 48 publications

(75 citation statements)

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“…For instance, positive associations for the expression of eGenes with coronary artery disease, stroke, and dementia were negatively associated with the lifespan. These chronic disorders are well known for their negative associations with the vital prognosis 77,78 .…”

Section: Discussionmentioning

confidence: 99%

Single-cell expression and Mendelian randomization analyses identify blood genes associated with lifespan and chronic diseases

et al. 2020

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The human lifespan is a heritable trait, which is intricately linked to the development of disorders. Here, we show that genetic associations for the parental lifespan are enriched in open chromatin of blood cells. By using blood expression quantitative trait loci (eQTL) derived from 31,684 samples, we identified for the lifespan 125 cisand 559 trans-regulated expressed genes (eGenes) enriched in adaptive and innate responses. Analysis of blood single-cell expression data showed that eGenes were enriched in dendritic cells (DCs) and the modelling of cell ligand-receptor interactions predicted crosstalk between DCs and a cluster of monocytes with a signature of cytotoxicity. In two-sample Mendelian randomization (MR), we identified 16 blood cis-eGenes causally associated with the lifespan. In MR, the majority of cis-eGene-disorder association pairs had concordant effects with the lifespan. The present work underlined that the lifespan is linked with the immune response and identifies eGenes associated with the lifespan and disorders.

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Section: Discussionmentioning

confidence: 99%

Single-cell expression and Mendelian randomization analyses identify blood genes associated with lifespan and chronic diseases

et al. 2020

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“…Dementia is the seventh leading cause of death worldwide (World Health Organization, 2017), and between 2000 and 2017, the age standardized death rate for dementia more than doubled in the US (Kramarow and Tejada-Vera, 2019). Family and friends, referred to as caregivers, provide the bulk of support to people with dementia and are estimated to be equivalent to a workforce of 40 million full-time employees worldwide (Wimo et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

Is preparation for end of life associated with pre-death grief in caregivers of people with dementia?

Moore

Crawley

Vickerstaff

et al. 2020

Int. Psychogeriatr.

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ABSTRACTObjectives:Family caregivers of people with dementia can experience loss and grief before death. We hypothesized that modifiable factors indicating preparation for end of life are associated with lower pre-death grief in caregivers.Design:Cross-sectional.Setting:Caregivers of people with dementia living at home or in a care home.Participants:In total, 150 caregivers, 77% female, mean age 63.0 (SD = 12.1). Participants cared for people with mild (25%), moderate (43%), or severe dementia (32%).Measurements:Primary outcome: Marwit-Meuser Caregiver Grief Inventory Short Form (MMCGI-SF). We included five factors reflecting preparation for end of life: (1) knowledge of dementia, (2) social support, (3) feeling supported by healthcare providers, (4) formalized end of life documents, and (5) end-of-life discussions with the person with dementia. We used multiple regression to assess associations between pre-death grief and preparation for end of life while controlling for confounders. We repeated this analysis with MMCGI-SF subscales (“personal sacrifice burden”; “heartfelt sadness”; “worry and felt isolation”).Results:Only one hypothesized factor (reduced social support) was strongly associated with higher grief intensity along with the confounders of female gender, spouse, or adult child relationship type and reduced relationship closeness. In exploratory analyses of MMCGI-SF subscales, one additional hypothesized factor was statistically significant; higher dementia knowledge was associated with lower “heartfelt sadness.”Conclusion:We found limited support for our hypothesis. Future research may benefit from exploring strategies for enhancing caregivers’ social support and networks as well as the effectiveness of educational interventions about the progression of dementia (ClinicalTrials.gov ID: NCT03332979).

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“…Thus, our measure of cognitive de cits is likely to capture a wide range of cognitive impairment. ADRD cases were identi ed through three-digit ICD-9-CM diagnostic codes (290, 294, 331, or 797) (3,13) or three-digit ICD-10 diagnostic codes (F01, F03, G30, and G31) (24). Because the transition to ICD-10 diagnostic codes was implemented in October 2015, we used the ICD-9-CM diagnostic codes for the data between 1997 and 2015 and the ICD-10 diagnostic codes for the data between 2015 and 2017.…”

Section: Data and Samplementioning

confidence: 99%

Racial and ethnic patterns and differences in health care expenditures among Medicare beneficiaries with and without cognitive deficits or Alzheimer's disease and related dementias

Park

Chen

2020

Preprint

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Background: Numerous studies have documented racial and ethnic differences in the prevalence and incidence of Alzheimer's disease and related dementias (ADRD). Less is known, however, about racial and ethnic differences in health care expenditures among older adults at risk for ADRD (cognitive deficits without ADRD) or with ADRD. In particular, there is limited evidence that racial and ethnic differences in health care expenditures change over the trajectory of ADRD or differ by types of service.Methods: We examined racial and ethnic patterns and differences in health care expenditures (total health care expenditures, out-of-pocket expenditures, and six service-specific expenditures) among Medicare beneficiaries without cognitive deficits, those with cognitive deficits without ADRD, and those with ADRD. Using the 1996-2017 Medical Expenditure Panel Survey, we performed multivariable regression models to estimate expenditure differences among racial and ethnic groups without cognitive deficits, those with cognitive deficits without ADRD, and those with ADRD. Models accounted for survey weights and adjusted for various demographic, socioeconomic, and health characteristics.Results: Asians and Latinos without cognitive deficits had lower total health care expenditures than whites without cognitive deficits ($10,236, $9,497, $9,597, and $11,541, respectively). There were no racial and ethnic differences in total health care expenditures among those with cognitive deficits without ADRD and those with ADRD. Across all three groups, however, blacks, Asians, and Latinos consistently had lower out-of-pocket expenditures than whites (except for Asians with cognitive deficits without ADRD). Furthermore, service-specific health care expenditures varied by racial and ethnic groups.Conclusions: Our study did not find significant racial and ethnic differences in total health care expenditures among Medicare beneficiaries with cognitive deficits and/or ADRD. However, we documented significant differences in out-of-pocket expenditures and service-specific expenditures. We speculated that the differences may be attributable to racial and ethnic differences in access to care and/or preferences based on family structure and cultural/economic factors. Particularly, heterogeneous patterns of service-specific expenditures by racial and ethnic groups underscore the importance of future research in identifying determinants leading to variations in service-specific expenditures among racial and ethnic groups.

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Dementia Mortality in the United States, 1999–2016

Cited by 48 publications

References 0 publications

Single-cell expression and Mendelian randomization analyses identify blood genes associated with lifespan and chronic diseases

Single-cell expression and Mendelian randomization analyses identify blood genes associated with lifespan and chronic diseases

Is preparation for end of life associated with pre-death grief in caregivers of people with dementia?

Racial and ethnic patterns and differences in health care expenditures among Medicare beneficiaries with and without cognitive deficits or Alzheimer's disease and related dementias

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