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以色列痴呆症诊断与治疗中的种族差异。

Ethnic Differences in Dementia Diagnosis and Treatment in Israel.

作者信息

Bishara Haya, Cohen Hilla, Hadar Dana, Specktor Polina

机构信息

Neurology Department, Carmel Medical Center, Haifa 3436212, Israel.

Research Department, Carmel Medical Center, Haifa 3436212, Israel.

出版信息

J Clin Med. 2025 Aug 22;14(17):5926. doi: 10.3390/jcm14175926.

Abstract

Lifestyle and socioeconomic disparities influence dementia prevalence and treatment across ethnic groups worldwide. Our study aimed to examine differences in the diagnosis, work-up, and treatment of mild cognitive impairment (MCI) as well as various types of dementia provided to Arab and Jewish participants in Israel. Data were collected retrospectively and anonymously between 1 January 2010 and 12 September 2021, by Clalit Health Services' research department. Ethnicity was determined based on residence, including only cities with a 99% majority of either Jewish or Arab participants, according to the Central Bureau of Statistics (CBS). Subjects over the age of 60 with an MCI or dementia diagnosis were analyzed. Of 212,091 diagnosed individuals, 14,742 were of a definite ethnicity as defined. The mean age at diagnosis was significantly younger for Arab participants (75.78 ± 10.28) compared to Jewish participants (80.14 ± 9.45) ( < 0.001). The gender distribution was similar (42.5% male). The most common diagnosis was Alzheimer's disease (AD), affecting 2495 (29.8%) of Jewish participants and 2387 (38%) of Arab participants ( < 0.001). Vascular dementia (VD) was also more prevalent in Arab participants, 12.6%, vs. 6.42% in Jewish participants ( < 0.001). MCI was more common in Jewish participants, 26.2%, compared to 10.3% in Arab participants ( < 0.001). Arab participants were diagnosed with dementia at a younger age and showed higher rates of AD and VD diagnosis compared to Jewish participants, but were significantly less likely to be diagnosed with MCI. Efforts to understand and address these underlying causes are warranted to promote health equity.

摘要

生活方式和社会经济差异影响着全球各民族的痴呆症患病率和治疗情况。我们的研究旨在调查以色列阿拉伯和犹太参与者在轻度认知障碍(MCI)以及各类痴呆症的诊断、检查和治疗方面的差异。数据由克拉利特医疗服务公司的研究部门于2010年1月1日至2021年9月12日进行回顾性收集且匿名处理。根据以色列中央统计局(CBS)的数据,种族是根据居住地确定的,仅纳入犹太或阿拉伯参与者占比达99%的城市。对年龄在60岁以上且被诊断为MCI或痴呆症的受试者进行了分析。在212,091名被诊断的个体中,有14,742名具有明确界定的种族。阿拉伯参与者的确诊平均年龄(75.78±10.28)明显低于犹太参与者(80.14±9.45)(<0.001)。性别分布相似(男性占42.5%)。最常见的诊断是阿尔茨海默病(AD),影响了2495名(29.8%)犹太参与者和2387名(38%)阿拉伯参与者(<0.001)。血管性痴呆(VD)在阿拉伯参与者中也更为普遍,占12.6%,而犹太参与者中为6.42%(<0.001)。MCI在犹太参与者中更为常见,占26.2%,而阿拉伯参与者中为10.3%(<0.001)。与犹太参与者相比,阿拉伯参与者被诊断为痴呆症的年龄更小,AD和VD的诊断率更高,但被诊断为MCI的可能性显著更低。有必要努力理解并解决这些潜在原因,以促进健康公平。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b6b2/12429298/4367e0f34582/jcm-14-05926-g001.jpg

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