Trends in Alzheimer Disease Mortality Among American Indian and Alaska Native People Between 2011 and 2019.

IF 1.8 4区 医学 Q3 CLINICAL NEUROLOGY Alzheimer Disease & Associated Disorders Pub Date : 2023-04-01 Epub Date: 2023-04-28 DOI:10.1097/WAD.0000000000000555
Solmaz Amiri, Luohua Jiang, Spero M Manson, Dedra S Buchwald
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Abstract

Purpose: The number of American Indian and Alaska Native (AI/AN) people living with dementia is expected to increase 5-fold by 2060. Social determinants of health may explain disparities in the incidence of Alzheimer disease (AD) but remain largely overlooked.

Methods: We examined the time trend of AD mortality rates and associations of the percentage of AI/ANs, density of primary care physicians and neurologists, area deprivation index, rurality, and Indian Health Service region with AD mortality in 646 purchased/referred care delivery area counties.

Results: AD mortality rates significantly increased over time. Counties with higher concentrations of AI/AN people had lower AD mortality. More deprived counties had 34% higher AD mortality compared with less deprived counties. AD mortality was 20% lower in nonmetro counties than in metro counties.

Conclusions: Findings have implications for prioritizing areas where more resources for AD care, education, or outreach are needed.

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2011年至2019年美国印第安人和阿拉斯加原住民阿尔茨海默病死亡率趋势。
目的:到2060年,患有痴呆症的美国印第安人和阿拉斯加原住民(AI/AN)人数预计将增加5倍。健康的社会决定因素可以解释阿尔茨海默病(AD)发病率的差异,但在很大程度上仍然被忽视。方法:我们调查了646个购买/转诊护理地区县的AD死亡率的时间趋势,以及AI/AN的百分比、初级保健医生和神经学家的密度、地区剥夺指数、农村和印度卫生服务地区与AD死亡率的关系。结果:随着时间的推移,AD死亡率显著增加。AI/AN人群浓度较高的县AD死亡率较低。与贫困程度较低的县相比,贫困程度较高的县AD死亡率高34%。非大都市县的AD死亡率比大都市县低20%。结论:研究结果对优先考虑需要更多资源用于AD护理、教育或外展的领域具有重要意义。
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来源期刊
CiteScore
3.10
自引率
4.80%
发文量
88
期刊介绍: ​Alzheimer Disease & Associated Disorders is a peer-reviewed, multidisciplinary journal directed to an audience of clinicians and researchers, with primary emphasis on Alzheimer disease and associated disorders. The journal publishes original articles emphasizing research in humans including epidemiologic studies, clinical trials and experimental studies, studies of diagnosis and biomarkers, as well as research on the health of persons with dementia and their caregivers. The scientific portion of the journal is augmented by reviews of the current literature, concepts, conjectures, and hypotheses in dementia, brief reports, and letters to the editor.
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