Incidence and prevalence of dementia in a multiethnic cohort of municipal retirees

Perkins, Penny; Annegers, J. F.; Doody, Rachelle S.; Cooke, Norma; Aday, Lu Ann; Vernon, Sally W.

doi:10.1212/wnl.49.1.44

Cited by 131 publications

(109 citation statements)

References 5 publications

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“…Prevalence studies in New Haven, Connecticut; Copiah County, Mississippi; Houston, Texas; New York, New York; Dade County, Florida; and East Baltimore, Maryland, have all found higher rates of dementia among elderly ethnic minority peoplespecifically African Americans and Hispanics-than among whites and Asians (Demirovic et al, 2003;Harwood & Ownby, 2000;Perkins et al, 1997). Among African Americans, prevalence estimates have been as high as 56 percent, although rates of diagnosed disease have been more in the 5 to 16 percent range (Teresi, Holmes, Ramirez, Gurland, & Lantigua, 2002).…”

Section: Prevalence Incidence Diagnosis and Phenotypesmentioning

confidence: 99%

Racial and Ethnic Disparities Among Individuals with Alzheimer’s Disease in the United States: A Literature Review

Lines¹,

Sherif²,

Wiener³

2014

115

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This study reviews the published literature on racial and ethnic disparities among people with Alzheimer’s disease (AD) and related dementias in the United States. To identify relevant studies, we searched electronic sources for peer-reviewed journal articles and unpublished research reports that were published through July 2014; related to the AD population and their caregivers; and provided evidence of racial and ethnic disparities, discussed reasons for disparities, or described interventions to address disparities. The literature shows consistent and adverse disparities among blacks and Hispanics compared with non-Hispanic whites concerning AD, including the disease’s prevalence and incidence, mortality, participation in clinical trials, use of medications and other interventions, use of long-term services and supports, health care expenditures, quality of care, and caregiving. The literature suggests numerous underlying causes, including factors related to measurement of the disease, genetics, socioeconomic factors, cultural differences, lack of culturally competent clinicians, and discrimination. Although these disparities are well known, little is known about the effectiveness of various strategies, such as cultural competence training, to address these differences, and very few studies evaluate possible interventions.

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Section: Prevalence Incidence Diagnosis and Phenotypesmentioning

confidence: 99%

Racial and Ethnic Disparities Among Individuals with Alzheimer’s Disease in the United States: A Literature Review

Lines¹,

Sherif²,

Wiener³

2014

115

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“…Alzheimer's disease (AD) is the most frequent cause of dementia in individuals over 64 years of age in industrialized countries [1]. In general, this disease con-stitutes a leading socioeconomic problem since individuals with dementia require a high amount of healthcare and social and economic services both for the patients as well as their family and caregivers [2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Prospective One-Year Cost-of-Illness Study in a Cohort of Patients with Dementia of Alzheimer's Disease Type in Spain: The ECO Study

Coduras

Rabasa

Frank

et al. 2010

JAD

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Abstract. In this study, we analyzed the economic impact of one-year healthcare and non-healthcare resources utilization by patients with dementia of Alzheimer's disease (AD) under usual medical practice in Spain. A one-year, prospective, naturalistic, multicenter cohort study was designed to recruit patients with mild, moderate to severe, and severe AD according to Clinical Dementia Rating scale: the ECO study. Healthcare resources (medical visits, drugs and concomitant treatments, complementary and diagnostic tests, institutionalization and use of home-nursing facilities) and non-healthcare resources (inventory materials, consumables, professional and non-professional caregivers' time for care and supervision) were recorded and valued at 2006 prices. A total of 560 patients with possible/probable AD by DSM-IV-NINCDS-ADRDA criteria were included in the study: 68% women, 77 ± 6 years old, 29% treatment naïve. Monthly average cost per patient was 1,425.73, and increased 10.08% at the end of the study (baseline monthly cost; 1,316.22). Non-healthcare costs ( 1059.00, 74.30% of total cost) decreased 4.30/month (0.40%) at the end of the year, while healthcare costs, which presented a total average of 366.66, grew by 136.94 in the period (54.06%), mainly due to cost of drugs, nursing home utilization, and institutionalization. The 87.26% of the overall cost ( 1,244.22) was not financed by National Health Service (NHS), and the majority of this cost corresponded to caregiver-associated cost. The caregiver's total burden represented 70.86% of the overall cost-of-illness. In conclusion, monthly overall mean cost of dementia of AD type was high in Spain ( 1,412.73). Almost 88% of the cost-of-illness is funded by the patient's own family, adding a financial burden to the suffering of these families.

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“…The determinants of cognitive dysfunction with increasing age are complex, multifactorial, and synergistic, involving features of the physical and social environments, as well as endogenous biologic (e.g., genetic) and behavioral factors. Although results are not entirely consistent (e.g., Munoz et al 2000), there is substantial evidence that neurobehavioral test scores, cognitive decline over time, and dementia risk vary substantially by race/ ethnicity (Fillenbaum et al 1998;Graham et al 1998;Gurland and Katz 1997;Gurland et al 1999;Hall et al 2000;Launer et al 1999;Perkins et al 1997;Shadlen et al 1999;Stern et al 1994;Wiederholt et al 1993). The underlying basis for these differences has not been clearly delineated.…”

mentioning

confidence: 96%

Disparities in cognitive functioning by race/ethnicity in the Baltimore Memory Study.

Schwartz

Glass

Bolla

et al. 2004

Environ Health Perspect

129

146

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The Baltimore Memory Study is a cohort study of the multilevel determinants of cognitive decline in 50-70-year-old randomly selected residents of specific city neighborhoods. Prior studies have demonstrated that cognitive function differs by race/ethnicity, with lower scores in minorities than in whites, but the underlying basis for these differences is not understood. Studies have differed in the rigor with which they evaluated and controlled for such important confounding variables as socioeconomic status (SES), health-related behaviors, comorbid illnesses, and factors in the physical environment. The goal of this study was to describe differences in neurobehavioral test scores by race/ethnicity, before and after control for a four-dimensional measure of SES and health-related behaviors and health conditions, in a cross-sectional analysis of first visit data. Random samples of households in the study area were selected until enrollment goals were reached. Among the 2,351 persons on whom eligibility was determined, 60.8% were scheduled for an enrollment visit; of these, 1,140 (81.3%) were enrolled and tested. These study participants were 34.3% male and 65.7% female and were from 65 Baltimore, Maryland, neighborhoods. After adjustment for age, sex, and testing technician, there were large and statistically significant differences in neurobehavioral test scores by race/ethnicity, with African-American scores lower than those for whites, for both men and women. After adjustment for individual SES (educational status, household income, household assets, and occupational status), the average difference declined by 25.8%. After additional adjustment for SES, health-related behaviors and health conditions, and blood lead, the average difference declined another 10%, but large differences persisted; African Americans had test scores that averaged 0.43 standard deviation lower than those for whites across all neurobehavioral tests. These differences were present in all cognitive domains, including tests that would not be characterized as susceptible to differential item functioning by race/ethnicity, suggesting that the results are not due to race/ethnicity-associated measurement error.

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Incidence and prevalence of dementia in a multiethnic cohort of municipal retirees

Abstract: Risk of dementia by age 80 was more pronounced for Hispanic and black men compared with white men. IVD was the predominant cause of dementia among both black and white men. Grouping Hispanics with whites may mask differences when studying dementia.

Cited by 131 publications

References 5 publications

Racial and Ethnic Disparities Among Individuals with Alzheimer’s Disease in the United States: A Literature Review

Racial and Ethnic Disparities Among Individuals with Alzheimer’s Disease in the United States: A Literature Review

Prospective One-Year Cost-of-Illness Study in a Cohort of Patients with Dementia of Alzheimer's Disease Type in Spain: The ECO Study

Disparities in cognitive functioning by race/ethnicity in the Baltimore Memory Study.

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