Arce Rentería Miguel, Mobley Taylor M, Evangelista Nicole D, Medina Luis D, Deters Kacie D, Fox-Fuller Joshua T, Minto Lex R, Avila-Rieger Justina, Bettcher Brianne M
Department of Neurology Taub Institute for Research on Alzheimer's Disease and the Aging Brain Columbia University College of Physicians and Surgeons Columbia University Medical Center New York City New York USA.
Department of Epidemiology University of California Los Angeles Fielding School of Public Health Los Angeles California USA.
Alzheimers Dement (Amst). 2023 Jun 5;15(2):e12450. doi: 10.1002/dad2.12450. eCollection 2023 Apr-Jun.
To generalize findings on the mechanisms and prognosis in Alzheimer's disease and related dementias (ADRD), it is critical for ADRD research to be representative of the population. Sociodemographic and health characteristics across ethnoracial groups included in the National Alzheimer's Coordinating Center sample (NACC) were compared to the nationally representative Health and Retirement Study (HRS). Baseline NACC data ( = 36,639) and the weighted 2010 HRS wave ( = 52,071,840) were included. We assessed covariate balance by calculating standardized mean differences across harmonized covariates (i.e., sociodemographic, health). NACC participants were older, more educated, with worse subjective memory and hearing, but endorsed fewer depressive symptoms compared to HRS participants. While all racial and ethnic groups in NACC differed from HRS participants in the same way overall, these differences were further amplified between racial and ethnic groups. NACC participants do not represent the U.S. population in key demographic and health factors, which differed by race and ethnicity.
We examined selection factors included in NACC studies compared to a nationally representative sample.Selection factors included demographic and health factors and self-reported memory concerns.Results suggest that NACC participants are not representative of the U.S. population.Importantly, selection factors differed across racial and ethnic groups.Findings are suggestive of selection bias within NACC studies.
为了归纳阿尔茨海默病及相关痴呆症（ADRD）的发病机制和预后方面的研究结果，ADRD研究具有人群代表性至关重要。将国家阿尔茨海默病协调中心样本（NACC）中纳入的不同种族群体的社会人口统计学和健康特征与具有全国代表性的健康与退休研究（HRS）进行了比较。纳入了NACC的基线数据（n = 36,639）和2010年HRS加权数据（n = 52,071,840）。我们通过计算统一协变量（即社会人口统计学、健康方面）的标准化均值差异来评估协变量平衡。与HRS参与者相比，NACC参与者年龄更大、受教育程度更高、主观记忆和听力更差，但抑郁症状更少。虽然NACC中的所有种族和族裔群体总体上与HRS参与者的差异方式相同，但这些差异在不同种族和族裔群体之间进一步放大。NACC参与者在关键人口统计学和健康因素方面不能代表美国人口，且这些因素因种族和族裔而异。
我们将NACC研究中包含的选择因素与具有全国代表性的样本进行了比较。选择因素包括人口统计学和健康因素以及自我报告的记忆问题。结果表明NACC参与者不能代表美国人口。重要的是，选择因素在不同种族和族裔群体中存在差异。研究结果提示NACC研究中存在选择偏倚。
