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Pathways explaining racial/ethnic and socio-economic disparities in incident all-cause dementia among older US adults across income groups.
Beydoun, May A; Beydoun, Hind A; Banerjee, Sri; Weiss, Jordan; Evans, Michele K; Zonderman, Alan B.
Afiliação
  • Beydoun MA; Laboratory of Epidemiology and Population Sciences, National Institutes on Aging, NIA/NIH/IRP, Baltimore, MD, USA. baydounm@mail.nih.gov.
  • Beydoun HA; Department of Research Programs, Fort Belvoir Community Hospital, Fort Belvoir, VA, US.
  • Banerjee S; College of Health Professions, School of Health Sciences, Walden University, Baltimore, MD, US.
  • Weiss J; Stanford Center on Longevity, Stanford University, Stanford, CA, US.
  • Evans MK; Laboratory of Epidemiology and Population Sciences, National Institutes on Aging, NIA/NIH/IRP, Baltimore, MD, USA.
  • Zonderman AB; Laboratory of Epidemiology and Population Sciences, National Institutes on Aging, NIA/NIH/IRP, Baltimore, MD, USA.
Transl Psychiatry ; 12(1): 478, 2022 11 15.
Article em En | MEDLINE | ID: mdl-36379922
Differential racial and socioeconomic disparities in dementia incidence across income groups and their underlying mechanisms remain largely unknown. A retrospective cohort study examining all-cause dementia incidence across income groups was conducted linking third National Health and Nutrition Examination Surveys (NHANES III) to Centers for Medicare and Medicaid Services-Medicare data over ≤26 y of follow-up (1988-2014). Cox regression and generalized structural equations models (GSEM) were constructed among adults aged≥60 y at baseline (N = 4,592). Non-Hispanic Black versus White (NHW) adults had higher risk of dementia in age and sex-adjusted Cox regression models (HR = 1.34, 95%CI: 1.15-1.55, P < 0.001), an association that was attenuated in the SES-adjusted model (HR = 1.15, 95%CI: 1.01-1.34, P = 0.092). SES was inversely related to dementia risk overall (per Standard Deviation, HR = 0.80, 95% CI:0.69-0.92, P = 0.002, Model 2), mainly within the middle-income group. Within the lowest and middle-income groups and in socio-economic status (SES)-adjusted models, Mexican American participants were at lower all-cause dementia risk compared with their NHW counterparts. GSEM models further detected 3 pathways explaining >55% of the total effect of SES on dementia risk (Total effect = -0.160 ± 0.067, p = 0.022), namely SES→LIFESTYLE→DEMENTIA (Indirect effect (IE) = -0.041 ± 0.014, p = 0.004), SES→LIFESTYLE→COGN→DEMENTIA (IE = -0.006 ± 0.001, p < 0.001), SES→COGN→DEMENTIA(IE = -0.040 ± 0.008, p < 0.001), with the last two remaining significant or marginally significant in the uppermost income groups. Diet and social support were among key lifestyle factors involved in socio-economic disparities in dementia incidence. We provide evidence for modifiable risk factors that may delay dementia onset differentially across poverty-income ratio groups, underscoring their importance for future observational and intervention studies.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Medicare / Demência Tipo de estudo: Diagnostic_studies / Health_economic_evaluation / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Humans / Middle aged País/Região como assunto: America do norte Idioma: En Revista: Transl Psychiatry Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Medicare / Demência Tipo de estudo: Diagnostic_studies / Health_economic_evaluation / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Humans / Middle aged País/Região como assunto: America do norte Idioma: En Revista: Transl Psychiatry Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Estados Unidos