Specktor Polina, Ben Hayun Rachel, Yarovinsky Natalia, Fisher Tali, Aharon Peretz Judith
Cognitive Neurology Institute, Rambam Health Care Campus, Haifa, Israel.
Technion - Israel Institute of Technology, Haifa, Israel.
Front Neurol. 2021 Jan 13;11:578068. doi: 10.3389/fneur.2020.578068. eCollection 2020.
Variations in lifestyle, socioeconomic status and general health likely account for differences in dementia disparities across racial groups. Our aim was to evaluate the characteristics of Arab (AS) and Jewish (JS) subjects attending a tertiary dementia clinic in Israel. Retrospective data regarding subjects attending the Cognitive Neurology Institute at Rambam Health Care Campus between April 1, 2010, and April 31, 2016, for complaints of cognitive decline were collected from the institutional registry. AS and consecutive JS, aged ≥50 years without a previous history of structural brain disease, were included. The records of 6,175 visits were found; 3,246 subjects were ≥50 years at the initial visit. One hundred and ninety-nine AS and consecutive JS cases were reviewed. Mean age at first visit was 68.4 ± 8.8 for AS and 74.3 for JS ( < 0.0001). Mean education was 7.7 ± 4.8 years for AS and 11.3 years for JS ( < 0.0001). Mean duration of cognitive complaints prior to first visit did not differ between the groups. Initial complaints of both ethnicities were failing memory (97%) and behavioral changes (59%). Functional impairment was reported by 59% of AS and 45% of JS ( = 0.005). MMSE on first evaluation was 19.2 ± 7 for AS and 23.1 ± 5.9 for JS; = 0.001. Alzheimer's disease was diagnosed in 32% AS and 23% JS, mild cognitive impairment in 12% AS and 21% JS. Normal cognition was diagnosed in 2% AS and 9% JS; = 0.0001. Compared to JS, AS attend a tertiary clinic when their cognitive impairment already affects their functional abilities providing a comprehensive benchmark for social health care interventions to reduce disparities.
生活方式、社会经济地位和总体健康状况的差异可能是不同种族群体在痴呆症差异方面存在差异的原因。我们的目的是评估在以色列一家三级痴呆症诊所就诊的阿拉伯裔（AS）和犹太裔（JS）患者的特征。从机构登记处收集了2010年4月1日至2016年4月31日期间在兰巴姆医疗保健校园认知神经学研究所就诊、主诉认知能力下降的患者的回顾性数据。纳入年龄≥50岁、既往无结构性脑病史的AS和连续的JS患者。共找到6175次就诊记录；3246名患者初次就诊时年龄≥50岁。对199例AS和连续的JS病例进行了回顾。AS患者初次就诊时的平均年龄为68.4±8.8岁，JS患者为74.3岁（P<0.0001）。AS患者的平均受教育年限为7.7±4.8年，JS患者为11.3年（P<0.0001）。两组患者初次就诊前认知主诉的平均持续时间无差异。两个种族的初始主诉均为记忆力减退（97%）和行为改变（59%）。59%的AS患者和45%的JS患者报告有功能障碍（P=0.005）。初次评估时，AS患者的简易精神状态检查表（MMSE）评分为19.2±7分，JS患者为23.1±5.9分；P=0.001。32%的AS患者和23%的JS患者被诊断为阿尔茨海默病，12%的AS患者和21%的JS患者被诊断为轻度认知障碍。2%的AS患者和9%的JS患者被诊断为认知正常；P=0.0001。与JS患者相比，AS患者在认知障碍已经影响其功能能力时才到三级诊所就诊，这为减少差异的社会医疗保健干预提供了一个全面的基准。
