Chithiramohan Tamara, Threlfall Grace, Abdelaziz Hanin, Ellahi Amira, Subramaniam Hari, Beishon Lucy, Mukaetova-Ladinska Elizabeta B
University of Leicester, Department of Cardiovascular Sciences, Leicester, UK.
Leicestershire Partnership NHS Trust, Leicester, UK.
J Alzheimers Dis. 2023;92(1):71-79. doi: 10.3233/JAD-220925.
The incidence of dementia in Black and Asian populations in the UK is set to rise. There is concern surrounding differences in services provided for different ethnic groups.
This study aimed to examine ethnic variations in survival, services accessed, and medication use across White, Black, and Asian groups in routine memory clinic setting.
We retrospectively examined referrals to a memory service between 2013 and 2021. A random sample of 104 White, 99 Asian, and 74 Black patients were analyzed for differences in support services, voluntary services, medication use, and survival rate.
There were statistically significant differences in survival of the Asian compared to the White group (Hazard ratio (HR = 2.17,95% confidence interval (CI) 1.23-3.85, p = 0.008)) following adjustment for age, gender, diagnosis, cognitive impairment, severity, access to support and voluntary services, and use of cholinesterase inhibitors, N-methyl-D-aspartate antagonists, and antipsychotics. The Asian group showed a statistically significantly reduction in access to support services compared to the White group (HR = 0.05, 95% CI 0.01-0.37, p = 0.003). In contrast, the survival rate was similar between the White and Black dementia patients.
We found significantly reduced survival and reduced access to support services in Asian compared to White patients with dementia. Further research is needed to investigate the generalizability of our results, and determine the cause, and consequent remedies of these associations in ethnic minority groups.
英国黑人和亚洲人群中痴呆症的发病率呈上升趋势。人们对为不同种族群体提供的服务差异表示担忧。
本研究旨在探讨在常规记忆诊所环境中，白种人、黑人和亚洲人群在生存情况、获得的服务以及药物使用方面的种族差异。
我们回顾性研究了2013年至2021年间转诊至记忆服务机构的患者。对104名白种人、99名亚洲人和74名黑人患者的随机样本进行分析，以比较他们在支持服务、志愿服务、药物使用和生存率方面的差异。
在对年龄、性别、诊断、认知障碍、严重程度、获得支持和志愿服务的情况以及使用胆碱酯酶抑制剂、N-甲基-D-天冬氨酸拮抗剂和抗精神病药物进行调整后，亚洲人与白种人相比，生存率存在统计学显著差异（风险比（HR）=2.17，95%置信区间（CI）1.23 - 3.85，p = 0.008）。与白种人相比，亚洲人获得支持服务的机会在统计学上显著减少（HR = 0.05，95% CI 0.01 - 0.37，p = 0.003）。相比之下，白种人和黑人痴呆症患者的生存率相似。
我们发现，与患有痴呆症的白种人患者相比，亚洲患者的生存率显著降低，获得支持服务的机会也减少。需要进一步研究以调查我们结果的普遍性，并确定这些关联在少数民族群体中的原因及相应的补救措施。
