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亨廷顿病相关死亡率模式:美国 1999-2019 年二十年死亡率趋势分析。

Huntington's Disease-Related Mortality Patterns: A Two-Decade Analysis of Mortality Trends in the United States, from 1999-2019.

机构信息

Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan.

Department of Internal Medicine, Foundation University Medical College, Islamabad, Pakistan.

出版信息

J Huntingtons Dis. 2024;13(3):329-338. doi: 10.3233/JHD-240037.


DOI:10.3233/JHD-240037
PMID:39213086
Abstract

BACKGROUND: Huntington's disease (HD) is an autosomal dominant, progressive neurodegenerative disorder debilitating mainly in adults. OBJECTIVE: This study aimed to assess the trends in HD-related mortality regarding various demographic factors. METHODS: Death certificates from the CDC WONDER were studied from 1999 to 2019, for HD-related mortality in adults aged 25 + years. Age-adjusted Mortality Rate (AAMR) per 100,000 persons and Annual Percentage Change (APC) were calculated and stratified by year, age groups, gender, race/ethnicity, state, census region, urbanization, and place of death. RESULTS: Between 1999 to 2019, 22,595 deaths occurred in adults due to HD. The AAMR increased from 0.43 to 0.54 during this period (APC = 0.50; 95% CI: 0.18 to 0.84). Old adults (65-85 + years) had the highest overall AAMR, followed by middle-aged adults (45-64 years) and young adults (25-44 years) (AAMR old: 1.01 vs. AAMR middle-age: 0.68 vs. AAMR young: 0.16). Men had slightly greater overall AAMRs than women (AAMR men: 0.54 vs. AAMR women: 0.48). When stratified by race, non-Hispanic (NH) Whites had significantly higher mortality rates than NH African Americans (AAMR NH White: 0.61 vs. NH African American: 0.35), while the AAMR were lowest in Hispanic/Latino (0.28). The AAMRs also showed variation by region (overall AAMR: Midwest: 0.63, Northeast: 0.47, West: 0.48, South: 0.46), and non-metropolitan areas had higher HD-related AAMR (0.66) than metropolitan areas (0.47). CONCLUSIONS: HD-related mortality in US adults has increased since 1999. Reflecting on the variations in trends observed, new strategies are required to optimize the quality of care in long-term care facilities.

摘要

背景:亨廷顿病(HD)是一种常染色体显性、进行性神经退行性疾病,主要影响成年人。

目的:本研究旨在评估与各种人口因素相关的 HD 相关死亡率趋势。

方法:从 1999 年至 2019 年,使用疾病预防控制中心 WONDER 中的死亡证明研究了 25 岁及以上成年人中与 HD 相关的死亡率。计算了每 10 万人的年龄调整死亡率(AAMR)和年度百分比变化(APC),并按年份、年龄组、性别、种族/民族、州、人口普查区、城市化程度和死亡地点进行分层。

结果:在 1999 年至 2019 年期间,有 22595 例成年人因 HD 死亡。在此期间,AAMR 从 0.43 增加到 0.54(APC=0.50;95%CI:0.18 至 0.84)。老年(65-85+岁)人群的总体 AAMR 最高,其次是中年(45-64 岁)和青年(25-44 岁)人群(老年 AAMR:1.01 vs. 中年 AAMR:0.68 vs. 青年 AAMR:0.16)。男性的总体 AAMR 略高于女性(男性 AAMR:0.54 vs. 女性 AAMR:0.48)。按种族分层时,非西班牙裔(NH)白人的死亡率明显高于非西班牙裔非裔美国人(NH 白人 AAMR:0.61 vs. NH 非裔美国人 AAMR:0.35),而西班牙裔/拉丁裔的 AAMR 最低(0.28)。区域也存在 AAMR 差异(总体 AAMR:中西部:0.63,东北部:0.47,西部:0.48,南部:0.46),非大都市地区的 HD 相关 AAMR 高于大都市地区(0.66 比 0.47)。

结论:自 1999 年以来,美国成年人中与 HD 相关的死亡率有所增加。考虑到观察到的趋势变化,需要制定新的策略来优化长期护理机构的护理质量。

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引用本文的文献

[1]
Disparities in Huntington's disease care and research.

Curr Opin Neurol. 2025-8-1

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