Department of Epidemiology & Prevention, Wake Forest University School of Medicine, Winston-Salem, NC.
Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC.
Alzheimers Dement. 2023 Jul;19(7):3119-3128. doi: 10.1002/alz.12947. Epub 2023 Feb 1.
Discrimination negatively impacts health and may contribute to racial/ethnic disparities in dementia risk.
Experiences of lifetime and everyday discrimination were assessed among 6509 Multi-Ethnic Study of Atherosclerosis (MESA) participants. We assessed the association of discrimination with incidence of dementia including adjustment for important risk factors, cohort attrition, and we assessed for effect modification by race/ethnicity.
Prevalence of any lifetime discrimination in MESA was 42%, highest among Black adults (72%). Over a median 15.7 years of follow-up, there were 466 incident cases of dementia. Lifetime discrimination, but not everyday discrimination, was associated with incident dementia (Wald p = 0.03). Individuals reporting lifetime discrimination in ≥2 domains (compared to none) had greater risk for dementia (hazard ratio: 1.40; 95%: 1.08, 1.82) after adjustment for sociodemographic, clinical, and behavioral risk factors. Associations did not differ by race/ethnicity.
These findings demonstrate an association of greater experiences of lifetime discrimination with incident dementia.
歧视会对健康产生负面影响，并可能导致痴呆风险的种族/民族差异。
在 6509 名动脉粥样硬化多民族研究（MESA）参与者中评估了终身和日常歧视的经历。我们评估了歧视与痴呆症发病率之间的关联，包括对重要风险因素、队列流失的调整，以及评估种族/民族的影响修饰作用。
在 MESA 中，任何终身歧视的患病率为 42%，黑人成年人（72%）最高。在中位数为 15.7 年的随访期间，有 466 例痴呆症的发病病例。终身歧视，但不是日常歧视，与痴呆症的发病有关（Wald p = 0.03）。与没有歧视的个体相比，报告在≥2 个领域存在终身歧视的个体患痴呆症的风险更高（风险比：1.40；95%置信区间：1.08，1.82），调整了社会人口统计学、临床和行为风险因素后。这些关联在种族/民族之间没有差异。
这些发现表明，更多的终身歧视经历与痴呆症的发病有关。
