Elizabeth Rose Mayeda1, M Maria Glymour1, Charles P Quesenberry2, Rachel A Whitmer3. 1. Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA. 2. Kaiser Permanente Division of Research, Oakland, CA, USA. 3. Kaiser Permanente Division of Research, Oakland, CA, USA; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA. Electronic address: Rachel.Whitmer@kp.org.
Abstract
INTRODUCTION: Reducing racial/ethnic disparities is a primary objective of the National Alzheimer's Plan (NAPA), yet direct comparisons within large samples representing diversity of the United States are lacking. METHODS: Dementia incidence from January 1, 2000 to December 31, 2013 and a 25-year cumulative risk in 274,283 health care members aged 64+ (n = 18,778 African-American, n = 4543 American Indian/Alaska Native [AIAN], n = 21,000 Latino, n = 440 Pacific Islander, n = 206,490 white, n = 23,032 Asian-Americans). Cox proportional hazard models were adjusted for age, sex, medical utilization, and comorbidities. RESULTS: Dementia incidence (n = 59,555) was highest for African-Americans (26.6/1000 person-years) and AIANs (22.2/1000 person-years); intermediate for Latinos (19.6/1000 person-years), Pacific Islanders (19.6/1000 person-years), and whites (19.3/1000 person-years) and lowest among Asian-Americans (15.2/1000 person-years). Risk was 65% greater for African-Americans (hazard ratio = 1.65; 95% confidence interval = 1.58-1.72) versus Asian-Americans. Cumulative 25-year risk at age 65 was as follows: 38% African-Americans, 35% AIANs, 32% Latino, 25% Pacific Islanders, 30% white, and 28% Asian-Americans. DISCUSSION: Dementia rates varied over 60% between groups, providing a comprehensive benchmark for the NAPA goal of reducing disparities.
INTRODUCTION: Reducing racial/ethnic disparities is a primary objective of the National Alzheimer's Plan (NAPA), yet direct comparisons within large samples representing diversity of the United States are lacking. METHODS:Dementia incidence from January 1, 2000 to December 31, 2013 and a 25-year cumulative risk in 274,283 health care members aged 64+ (n = 18,778 African-American, n = 4543 American Indian/Alaska Native [AIAN], n = 21,000 Latino, n = 440 Pacific Islander, n = 206,490 white, n = 23,032 Asian-Americans). Cox proportional hazard models were adjusted for age, sex, medical utilization, and comorbidities. RESULTS:Dementia incidence (n = 59,555) was highest for African-Americans (26.6/1000 person-years) and AIANs (22.2/1000 person-years); intermediate for Latinos (19.6/1000 person-years), Pacific Islanders (19.6/1000 person-years), and whites (19.3/1000 person-years) and lowest among Asian-Americans (15.2/1000 person-years). Risk was 65% greater for African-Americans (hazard ratio = 1.65; 95% confidence interval = 1.58-1.72) versus Asian-Americans. Cumulative 25-year risk at age 65 was as follows: 38% African-Americans, 35% AIANs, 32% Latino, 25% Pacific Islanders, 30% white, and 28% Asian-Americans. DISCUSSION: Dementia rates varied over 60% between groups, providing a comprehensive benchmark for the NAPA goal of reducing disparities.
Authors: Marie-Florence Shadlen; David Siscovick; Annette L Fitzpatrick; Corinne Dulberg; Lewis H Kuller; Sharon Jackson Journal: J Am Geriatr Soc Date: 2006-06 Impact factor: 5.562
Authors: Denis A Evans; David A Bennett; Robert S Wilson; Julia L Bienias; Martha Clare Morris; Paul A Scherr; Liesi E Hebert; Neelum Aggarwal; Laurel A Beckett; Rajiv Joglekar; Elizabeth Berry-Kravis; Julie Schneider Journal: Arch Neurol Date: 2003-02
Authors: Thomas J Montine; Walter J Koroshetz; Debra Babcock; Dennis W Dickson; Wendy R Galpern; M Maria Glymour; Steven M Greenberg; Michael L Hutton; David S Knopman; Andrey N Kuzmichev; Jennifer J Manly; Karen S Marder; Bruce L Miller; Creighton H Phelps; William W Seeley; Beth-Anne Sieber; Nina B Silverberg; Margaret Sutherland; Christine L Torborg; Salina P Waddy; Berislav V Zlokovic; Roderick A Corriveau Journal: Neurology Date: 2014-07-30 Impact factor: 9.910
Authors: Wayne J Katon; Elizabeth H B Lin; Lisa H Williams; Paul Ciechanowski; Susan R Heckbert; Evette Ludman; Carolyn Rutter; Paul K Crane; Malia Oliver; Michael Von Korff Journal: J Gen Intern Med Date: 2010-01-28 Impact factor: 5.128
Authors: Jennifer Weuve; Cécile Proust-Lima; Melinda C Power; Alden L Gross; Scott M Hofer; Rodolphe Thiébaut; Geneviève Chêne; M Maria Glymour; Carole Dufouil Journal: Alzheimers Dement Date: 2015-09 Impact factor: 21.566
Authors: Elizabeth R Mayeda; M Maria Glymour; Charles P Quesenberry; Rachel A Whitmer Journal: Alzheimer Dis Assoc Disord Date: 2017 Jul-Sep Impact factor: 2.703
Authors: Kyle D Moored; Thomas Chan; Vijay R Varma; Yi-Fang Chuang; Jeanine M Parisi; Michelle C Carlson Journal: J Gerontol B Psychol Sci Soc Sci Date: 2020-09-14 Impact factor: 4.077
Authors: Kirby G Parker; Seth T Lirette; David S Deardorff; Lawrence F Bielak; Patricia A Peyser; J Jeffrey Carr; James G Terry; Myriam Fornage; Emelia J Benjamin; Stephen T Turner; Thomas H Mosley; Michael E Griswold; B Gwen Windham Journal: J Gerontol A Biol Sci Med Sci Date: 2018-03-14 Impact factor: 6.053
Authors: Paola Gilsanz; Charles P Quesenberry; Elizabeth Rose Mayeda; M Maria Glymour; Sarah T Farias; Rachel A Whitmer Journal: Alzheimer Dis Assoc Disord Date: 2019 Jul-Sep Impact factor: 2.703
Authors: Paola Gilsanz; Elizabeth Rose Mayeda; Jason Flatt; M Maria Glymour; Charles P Quesenberry; Rachel A Whitmer Journal: Alzheimer Dis Assoc Disord Date: 2018 Oct-Dec Impact factor: 2.703