Research Department, Southcentral Foundation, Anchorage, AK, USA.
Institute for Research and Education to Advance Community Health, Washington State University, Seattle, WA, USA.
Alzheimers Dement. 2019 Nov;15(11):1412-1419. doi: 10.1016/j.jalz.2019.06.4945. Epub 2019 Sep 25.
The prevalence, mortality, and healthcare impact of Alaska Native and American Indian (ANAI) people with Alzheimer's disease and related dementias (ADRD) are unknown.
We conducted a cohort study of electronic health record data that compared healthcare service utilization in patients with and without an ADRD diagnosis. Zero-inflated negative binomial regression with robust standard errors was used to estimate utilization rates.
Compared with patients without ADRD, utilization rates were similar before but higher after ADRD diagnosis. For those with diagnosed ADRD, utilization increased gradually over time with sharp upward change during the year of diagnosis.
This is the only study quantifying changes in healthcare service utilization before and after ADRD diagnosis among ANAI people, which is crucial for tailoring geriatric care for ANAI populations.
患有阿尔茨海默病和相关痴呆症（ADRD）的阿拉斯加原住民和美洲印第安人（ANAI）的流行率、死亡率和医疗保健影响尚不清楚。
我们进行了一项电子健康记录数据的队列研究，比较了有和没有 ADRD 诊断的患者的医疗服务利用情况。使用具有稳健标准误差的零膨胀负二项式回归来估计利用率。
与没有 ADRD 的患者相比，在 ADRD 诊断之前，利用率相似，但在诊断后更高。对于那些被诊断患有 ADRD 的患者，随着时间的推移，利用率逐渐增加，在诊断当年急剧上升。
这是唯一一项在 ANAI 人群中量化 ADRD 诊断前后医疗服务利用变化的研究，这对于为 ANAI 人群量身定制老年护理至关重要。
