Kaiser Permanente Division of Research, Oakland, CA, USA.
Department of Neurology, University of California, Irvine, Irvine, CA, USA; Department of Epidemiology, University of California, Irvine, Irvine, CA, USA.
Alzheimers Dement. 2019 Apr;15(4):497-505. doi: 10.1016/j.jalz.2018.12.006. Epub 2019 Feb 20.
Little is known about dementia incidence in diverse populations of oldest-old, the age group with highest dementia incidence.
Incident dementia diagnoses from 1/1/2010 to 9/30/2015 were abstracted from medical records for 2350 members of an integrated health care system in California (n = 1702 whites, n = 375 blacks, n = 105 Latinos, n = 168 Asians) aged ≥90 in 2010. We estimated race/ethnicity-specific age-adjusted dementia incidence rates and implemented Cox proportional hazards models and Fine and Gray competing risk of death models adjusted for demographics and comorbidities in midlife and late-life.
Dementia incidence rates (n = 771 cases) were lowest among Asians (89.9/1000 person-years), followed by whites (96.9/1000 person-years), Latinos (105.8/1000 person-years), and blacks (121.5/1000 person-years). Cox regression and competing risk models estimated 28% and 36% higher dementia risk for blacks versus whites adjusting for demographics and comorbidities.
Patterns of racial/ethnic disparities in dementia seen in younger older adults continue after the age of 90 years, though smaller in magnitude.
对于最高痴呆发病率的年龄组——最年长的老年人,我们对其不同人群的痴呆发病率知之甚少。
从 2010 年 1 月 1 日至 2015 年 9 月 30 日,从加利福尼亚州一个综合医疗保健系统的 2350 名成员(n=1702 名白人,n=375 名黑人,n=105 名拉丁裔,n=168 名亚裔)的医疗记录中提取出痴呆的发病诊断。我们估计了特定种族/族裔的年龄调整后痴呆发病率,并实施了 Cox 比例风险模型和 Fine 和 Gray 竞争死亡风险模型,以调整中年和晚年的人口统计学和合并症。
痴呆发病率(n=771 例)最低的是亚洲人(89.9/1000 人年),其次是白人(96.9/1000 人年)、拉丁裔(105.8/1000 人年)和黑人(121.5/1000 人年)。Cox 回归和竞争风险模型估计,调整人口统计学和合并症后,黑人患痴呆症的风险比白人高 28%和 36%。
在 90 岁以上的人群中,年轻老年人中存在的种族/族裔痴呆差异模式仍在继续,尽管程度较小。