Racial disparities in an aging population: The relationship between age and race in the management of African American men with high-risk prostate cancer

Mahal, Brandon A.; Ziehr, David R.; Aizer, Ayal A.; Hyatt, Andrew S.; Lago-Hernandez, Carlos; Choueiri, Toni K.; Elfiky, Aymen; Hu, Jim C.; Sweeney, Christopher J.; Beard, Clair J.; D’Amico, Anthony V.; Martin, Neil E.; Kim, Simon P.; Lathan, Christopher S.; Trinh, Quoc Dien; Nguyen, Paul L.

doi:10.1016/j.jgo.2014.05.001

Cited by 19 publications

(24 citation statements)

References 31 publications

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“…In addition, ample evidence suggests that racial and ethnic minorities, especially blacks and Mexican-Americans, have poorer access to quality healthcare than whites in the USA. [26][27][28][29][30][31][32][33][34][35][36][37] These findings highlight the significant need to improve access to healthcare services for Mexican-Americans and blacks so that aggressively combining early detection strategies with delivery of evidencebased therapeutic interventions at early stages can help prevent CKD progression. However, caution must be used in the overall interpretation of the results stratified by race due to some small sample sizes, especially in CKD stages 3b-5.…”

Section: Antihypertensive Medicationsmentioning

confidence: 99%

“…Under this system, KDOQI recommended avoiding glyburide treatment in stages 3-5 of CKD, and initiating treatment with other agents, using appropriate dose adjustments, and urges special care with metformin. The Kidney Disease: Improving Global Outcomes (KDIGO) updated CKD staging in 2012, accounting for the presence of albuminuria, and subdividing stage 3 into 3a (eGFR 45-59) and 3b (eGFR [30][31][32][33][34][35][36][37][38][39][40][41][42][43][44]. 1 Traditionally, eGFR has been calculated with the well-established Modification of Diet in Renal Disease (MDRD) equation, which consists of four variables: age, sex, race/ ethnicity, and serum creatinine concentration.…”

Section: Introductionmentioning

confidence: 99%

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Understanding CKD among patients with T2DM: prevalence, temporal trends, and treatment patterns—NHANES 2007–2012

Bell

Stanford

et al. 2016

BMJ Open Diab Res Care

164

113

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ObjectiveTo describe the estimated prevalence and temporal trends of chronic kidney disease (CKD) treatment patterns, and the association between CKD and potential factors for type 2 diabetes mellitus (T2DM) in different demographic subgroups.Research design and methodsThis was a cross-sectional analysis of adults with T2DM based on multiple US National Health and Nutrition Examination Survey (NHANES) datasets developed during 2007–2012. CKD severity was defined according to the Kidney Disease: Improving Global Outcomes (KDIGO) 2012 guidelines using the CKD Epidemiology Collaboration (CKD-EPI) equation: mild to moderate=stages 1–3a; moderate to kidney failure=stages 3b–5. Multivariable logistic regression analyses were performed to assess the associations between CKD and potential factors.ResultsOf the adult individuals with T2DM (n=2006), age-adjusted CKD prevalence was 38.3% during 2007–2012; 77.5% were mild-to-moderate CKD. The overall age-adjusted prevalence of CKD was 40.2% in 2007–2008, 36.9% in 2009–2010, and 37.6% in 2011–2012. The prevalence of CKD in T2DM was 58.7% in patients aged ≥65 years, 25.7% in patients aged <65 years, 43.5% in African-Americans and Mexican-Americans, and 38.7% in non-Hispanic whites. The use of antidiabetes and antihypertensive medications generally followed treatment guideline recommendations. Older age, higher hemoglobin A1c (HbA1c), systolic blood pressure (SBP), and having hypertension were significantly associated with CKD presence but not increasing severity of CKD.ConclusionsCKD continued to be prevalent in the T2DM population; prevalence remained fairly consistent over time, suggesting that current efforts to prevent CKD could be improved overall, especially by monitoring certain populations more closely.

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Section: Antihypertensive Medicationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Understanding CKD among patients with T2DM: prevalence, temporal trends, and treatment patterns—NHANES 2007–2012

Bell

Stanford

et al. 2016

BMJ Open Diab Res Care

164

113

View full text Add to dashboard Cite

show abstract

“…African Americans men waited longer between diagnosis and treatment than white men after adjusting for age, annual household income, level of education, and health insurance status [6]. In addition, among 62,644 high-risk and nonmetastatic cases (PSA >20 ng/mL, Gleason score of 8–10, or stage≥cT3a) in the SEER data, the African American patients were more likely to exhibit elevated PSA levels (17.6% vs. 9.9%, P<0.001) [11]. …”

Section: Diagnosismentioning

confidence: 99%

Racial Differences in the Diagnosis and Treatment of Prostate Cancer

et al. 2016

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Disparities between African American and Caucasian men in prostate cancer (PCa) diagnosis and treatment in the United States have been well established, with significant racial disparities documented at all stages of PCa management, from differences in the type of treatment offered to progression-free survival or death. These disparities appear to be complex in nature, involving biological determinants as well as socioeconomic and cultural aspects. We present a review of the literature on racial disparities in the diagnosis of PCa, treatment, survival, and genetic susceptibility. Significant differences were found among African Americans and whites in the incidence and mortality rates; namely, African Americans are diagnosed with PCa at younger ages than whites and usually with more advanced stages of the disease, and also undergo prostate-specific antigen testing less frequently. However, the determinants of the high rate of incidence and aggressiveness of PCa in African Americans remain unresolved. This pattern can be attributed to socioeconomic status, detection occurring at advanced stages of the disease, biological aggressiveness, family history, and differences in genetic susceptibility. Another risk factor for PCa is obesity. We found many discrepancies regarding treatment, including a tendency for more African American patients to be in watchful waiting than whites. Many factors are responsible for the higher incidence and mortality rates in African Americans. Better screening, improved access to health insurance and clinics, and more homogeneous forms of treatment will contribute to the reduction of disparities between African Americans and white men in PCa incidence and mortality.

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“…These results suggest possible racial/ethnic differences in the somatosensory system and in patho-physiological mechanisms. Indeed, compared to Caucasians, older racial/ethnic minority individuals are facing even higher health disparities than their younger counterpart in receiving needed medical care such as prostate cancer treatment [111]. More efforts should be made to reduce race/ethnicity-related disparities in geriatric care.…”

Section: Discussionmentioning

confidence: 99%

The Relationship of Older Adults' Physical Pain to Depression and Post-Traumatic Stress Disorder (PTSD): A Review

Alamdari

Laganá

2016

J Geriatr Med Gerontol

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Background Physical pain is very common in older age and is often accompanied by depressive as well as PTSD symptomatology. Many conceptualizations of the comorbidity of pain with depression and with PTSD exist, but they need to be tested on older adult populations. Purpose This article covers existing literature on the relation between depression and pain in older age, as well as between older adults’ PTSD and pain. Additionally, several physiological, cognitive, and behavioral conceptualizations of why depression and PTSD are often related to pain are presented. Methods The PsychInfo, PubMed, and Google Scholar databases were searched for relevant articles by utilizing the following terms in combination with chronic pain (as well as with pain alone): aging, older adults, elderly, depression, depressive, post-traumatic stress, and PTSD. Additionally, Thomson Reuters Web of Science database searches were conducted using the terms “elderly (and older adults) pain depression PTSD.” This review includes various articles that conceptualize the pain-depression, pain-PTSD, and pain-depression-PTSD links, yet, due to space limitations, the review is not comprehensive. Several pertinent reviews are referenced throughout the paper for readers interested in obtaining additional information in this area. Results Depression and PTSD are comorbidities for pain at any age, and are characterized by several and often complex mechanisms that can exacerbate pain. Conclusion The comorbidity of pain and factors such as depression and PTSD in older age should be addressed in more research studies, as few investigations are available in this area on the general population of older individuals. This is particularly the case for non-Caucasian older adults living with chronic pain.

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Racial disparities in an aging population: The relationship between age and race in the management of African American men with high-risk prostate cancer

Cited by 19 publications

References 31 publications

Understanding CKD among patients with T2DM: prevalence, temporal trends, and treatment patterns—NHANES 2007–2012

Understanding CKD among patients with T2DM: prevalence, temporal trends, and treatment patterns—NHANES 2007–2012

Racial Differences in the Diagnosis and Treatment of Prostate Cancer

The Relationship of Older Adults' Physical Pain to Depression and Post-Traumatic Stress Disorder (PTSD): A Review

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