Division of Rehabilitation Sciences, School of Health Professions, University of Texas Medical Branch, Galveston, TX, USA.
Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, USA.
J Alzheimers Dis. 2021;82(4):1727-1736. doi: 10.3233/JAD-210361.
Hispanic older adults are a high-risk population for Alzheimer's disease and related dementias (ADRD) but are less likely than non-Hispanic White older adults to have ADRD documented as a cause of death on a death certificate.
To investigate characteristics associated with ADRD as a cause of death among Mexican-American decedents diagnosed with ADRD.
Data came from the Hispanic Established Populations for the Epidemiologic Study of the Elderly, Medicare claims, and National Death Index.
The final sample included 853 decedents diagnosed with ADRD of which 242 had ADRD documented as a cause of death. More health comorbidities (OR = 0.40, 95% CI = 0.28-0.58), older age at death (OR = 1.18, 95% CI = 1.03-1.36), and longer ADRD duration (OR = 1.08, 95% CI = 1.03-1.14) were associated with ADRD as a cause of death. In the last year of life, any ER admission without a hospitalization (OR = 0.45, 95% CI = 0.22-0.92), more physician visits (OR = 0.96, 95% CI = 0.93-0.98), and seeing a medical specialist (OR = 0.46, 95% CI = 0.29-0.75) were associated with lower odds for ADRD as a cause of death. In the last 30 days of life, any hospitalization with an ICU stay (OR = 0.55, 95% CI = 0.36-0.82) and ER admission with a hospitalization (OR = 0.67, 95% CI = 0.48-0.94) were associated with lower odds for ADRD as a cause of death. Receiving hospice care in the last 30 days of life was associated with 1.98 (95% CI = 1.37-2.87) higher odds for ADRD as a cause of death.
Under-documentation of ADRD as a cause of death may reflect an underestimation of resource needs for Mexican-Americans with ADRD.
西班牙裔老年人是阿尔茨海默病和相关痴呆症（ADRD）的高危人群，但与非西班牙裔白人老年人相比，ADRD 作为死亡证明上的死因的记录较少。
调查与墨西哥裔美国死者 ADRD 死因相关的特征，这些死者被诊断患有 ADRD。
数据来自西班牙裔老年人的既定人群流行病学研究、医疗保险索赔和国家死亡指数。
最终样本包括 853 名被诊断患有 ADRD 的死者，其中 242 名 ADRD 被记录为死因。更多的健康合并症（OR=0.40，95%CI=0.28-0.58）、死亡时年龄较大（OR=1.18，95%CI=1.03-1.36）和更长的 ADRD 持续时间（OR=1.08，95%CI=1.03-1.14）与 ADRD 作为死因相关。在生命的最后一年，任何无住院的急诊入院（OR=0.45，95%CI=0.22-0.92）、更多的医生就诊（OR=0.96，95%CI=0.93-0.98）和看专科医生（OR=0.46，95%CI=0.29-0.75）与 ADRD 作为死因的可能性降低相关。在生命的最后 30 天，任何 ICU 住院的住院治疗（OR=0.55，95%CI=0.36-0.82）和急诊入院伴住院治疗（OR=0.67，95%CI=0.48-0.94）与 ADRD 作为死因的可能性降低相关。在生命的最后 30 天接受临终关怀与 ADRD 作为死因的可能性增加 1.98 倍（95%CI=1.37-2.87）相关。
ADRD 作为死因的记录不足可能反映了对患有 ADRD 的墨西哥裔美国人资源需求的低估。
