Mayeda Elizabeth R, Glymour M Maria, Quesenberry Charles P, Johnson Julene K, Pérez-Stable Eliseo J, Whitmer Rachel A
Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA.
Kaiser Permanente Division of Research, Oakland, CA, USA.
Alzheimers Dement. 2017 Jul;13(7):761-769. doi: 10.1016/j.jalz.2016.12.008. Epub 2017 Feb 5.
Information on anticipated survival time after dementia diagnosis among racially/ethnically diverse patients is needed to plan for care and evaluate disparities.
Dementia-free health care members aged ≥64 years were followed (1/1/2000-12/31/2013) for dementia diagnosis and subsequent survival (n = 23,032 Asian American; n = 18,778 African American; n = 21,000 Latino; n = 4543 American Indian/Alaska Native; n = 206,490 white). Kaplan-Meier curves were estimated for survival after dementia diagnosis by race/ethnicity. We contrasted mortality patterns among people with versus without dementia using Cox proportional hazards models.
After dementia diagnosis (n = 59,494), whites had shortest median survival (3.1 years), followed by American Indian/Alaska Natives (3.4 years), African Americans (3.7 years), Latinos (4.1 years), and Asian Americans (4.4 years). Longer postdiagnosis survival among racial/ethnic minorities compared with whites persisted after adjustment for comorbidities. Racial/ethnic mortality inequalities among dementia patients mostly paralleled mortality inequalities among people without dementia.
Survival after dementia diagnosis differs by race/ethnicity, with shortest survival among whites and longest among Asian Americans.
为了规划护理并评估差异,需要了解不同种族/族裔痴呆症患者诊断后的预期生存时间信息。
对年龄≥64岁且无痴呆症的医疗保健人员进行随访(2000年1月1日至2013年12月31日),以确定痴呆症诊断及随后的生存情况(n = 23,032名亚裔美国人;n = 18,778名非裔美国人;n = 21,000名拉丁裔;n = 4,543名美洲印第安人/阿拉斯加原住民;n = 206,490名白人)。通过种族/族裔估计痴呆症诊断后的生存情况的Kaplan-Meier曲线。我们使用Cox比例风险模型对比了有痴呆症和无痴呆症人群的死亡率模式。
在痴呆症诊断后(n = 59,494),白人的中位生存时间最短(3.1年),其次是美洲印第安人/阿拉斯加原住民(3.4年)、非裔美国人(3.7年)、拉丁裔(4.1年)和亚裔美国人(4.4年)。在对合并症进行调整后,种族/族裔少数群体与白人相比,诊断后的生存时间更长。痴呆症患者中的种族/族裔死亡率不平等情况大多与无痴呆症人群中的死亡率不平等情况相似。
痴呆症诊断后的生存情况因种族/族裔而异。白人的生存时间最短,亚裔美国人最长。