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健康与退休研究中歧视经历与痴呆症之间的关联。

Associations between discriminatory experiences and dementia in the Health and Retirement Study.

作者信息

Tyan Jean, Thorpe Roland J, Ladd-Acosta Christine, Dickerson Aisha S

机构信息

Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.

Department of Health, Behavior and Society, Hopkins Center for Health Disparities Solutions, Johns Hopkins Alzheimer's Disease Resource Center for Minority Aging Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.

出版信息

Soc Psychiatry Psychiatr Epidemiol. 2025 Feb 7. doi: 10.1007/s00127-025-02822-6.

Abstract

Dramatic racial and ethnic disparities in dementia necessitate research into potential risk factors and points of intervention. Using data from a large sample (n = 13,733) of older US residents participating in the Health and Retirement Study between 2006 and 2016, we investigated relationships between everyday and major discrimination and development of dementia. Data on self-reported everyday and major discrimination were collected via questionnaires. Algorithmic classification of probable dementia status was determined via a battery of cognitive tests. We used logistic regression models, and analyses were stratified by race and ethnicity and sex. We found that overall, more frequent experiences of everyday discrimination were associated with higher odds of developing dementia (odds ratio (OR) = 1.18; 95% confidence interval (CI): 1.10, 1.27; p < 0.001). Estimates stratified by race similarly suggested the positive association between everyday discrimination and odds of dementia onset was highest in non-Hispanic Black participants (OR: 1.30; 95% CI: 1.13, 1.51; p < 0.001). Our results reveal a link between frequency of everyday experiences of discrimination and dementia onset and highlight the role of psychosocial exposures in health and disease. This study underlines the impact that psychosocial stressors can have on cognitive health. Interventions addressing psychosocial risk factors experienced disproportionately by historically marginalized groups may be crucial in the goal to mitigate dementia disparities and achieve dementia equity.

摘要

痴呆症方面显著的种族和族裔差异使得有必要对潜在风险因素和干预点进行研究。利用2006年至2016年间参与健康与退休研究的大量美国老年居民样本(n = 13733)的数据,我们调查了日常歧视和重大歧视与痴呆症发生之间的关系。通过问卷收集了关于自我报告的日常歧视和重大歧视的数据。通过一系列认知测试确定可能痴呆状态的算法分类。我们使用逻辑回归模型,分析按种族、族裔和性别进行分层。我们发现,总体而言,更频繁地经历日常歧视与患痴呆症的几率更高相关(优势比(OR)= 1.18;95%置信区间(CI):1.10,1.27;p < 0.001)。按种族分层的估计同样表明,日常歧视与痴呆症发病几率之间的正相关在非西班牙裔黑人参与者中最高(OR:1.30;95% CI:1.13,1.51;p < 0.001)。我们的研究结果揭示了日常歧视经历的频率与痴呆症发病之间的联系,并突出了心理社会暴露在健康和疾病中的作用。这项研究强调了心理社会压力源对认知健康可能产生的影响。针对历史上被边缘化群体不成比例地经历的心理社会风险因素的干预措施,对于减轻痴呆症差异和实现痴呆症公平的目标可能至关重要。

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