View in EDS

Racial, ethnic and neighborhood socioeconomic differences in incidence of dementia: A regional retrospective cohort study.

Saved in:
Bibliographic Details
Title: Racial, ethnic and neighborhood socioeconomic differences in incidence of dementia: A regional retrospective cohort study.
Authors: Becerril, Alissa, Pfoh, Elizabeth R., Hashmi, Ardeshir Z., Mourany, Lyla, Gunzler, Douglas D., Berg, Kristen A., Krieger, Nikolas I., Krishnan, Kamini, Moore, Scott Emory, Kahana, Eva, Dawson, Neal V., Luezas Shamakian, Lorella, Campbell, James W., Perzynski, Adam T., Dalton, Jarrod E.
Source: Journal of the American Geriatrics Society. Aug2023, Vol. 71 Issue 8, p2406-2418. 13p.
Subjects: Dementia risk factors, Confidence intervals, Race, Retrospective studies, Socioeconomic factors, Risk assessment, Dementia, Descriptive statistics, Factor analysis, Research funding, Spatial behavior, Neighborhood characteristics, Longitudinal method
Geographic Terms: Ohio
Abstract: Background: Evidence on the effects of neighborhood socioeconomic disadvantage on dementia risk in racially and ethically diverse populations is limited. Our objective was to evaluate the relative extent to which neighborhood disadvantage accounts for racial/ethnic variation in dementia incidence rates. Secondarily, we evaluated the spatial relationship between neighborhood disadvantage and dementia risk. Methods: In this retrospective study using electronic health records (EHR) at two regional health systems in Northeast Ohio, participants included 253,421 patients aged >60 years who had an outpatient primary care visit between January 1, 2005 and December 31, 2015. The date of the first qualifying visit served as the study baseline. Cumulative incidence of composite dementia outcome, defined as EHR‐documented dementia diagnosis or dementia‐related death, stratified by neighborhood socioeconomic deprivation (as measured by Area Deprivation Index) was determined by competing‐risk regression analysis, with non‐dementia‐related death as the competing risk. Fine‐Gray sub‐distribution hazard ratios were determined for neighborhood socioeconomic deprivation, race/ethnicity, and clinical risk factors. The degree to which neighborhood socioeconomic position accounted for racial/ethnic disparities in the incidence of composite dementia outcome was evaluated via mediation analysis with Poisson rate models. Results: Increasing neighborhood disadvantage was associated with increased risk of EHR‐documented dementia diagnosis or dementia‐related death (most vs. least disadvantaged ADI quintile HR = 1.76, 95% confidence interval = 1.69–1.84) after adjusting for age and sex. The effect of neighborhood disadvantage on this composite dementia outcome remained after accounting for known medical risk factors of dementia. Mediation analysis indicated that neighborhood disadvantage accounted for 34% and 29% of the elevated risk for composite dementia outcome in Hispanic and Black patients compared to White patients, respectively. Conclusion: Neighborhood disadvantage is related to the risk of EHR‐documented dementia diagnosis or dementia‐related death and accounts for a portion of racial/ethnic differences in dementia burden, even after adjustment for clinically important confounders. [ABSTRACT FROM AUTHOR]
Copyright of Journal of the American Geriatrics Society is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
FullText Text:
  Availability: 0
Header DbId: pbh
DbLabel: Psychology and Behavioral Sciences Collection
An: 169783524
AccessLevel: 6
PubType: Academic Journal
PubTypeId: academicJournal
PreciseRelevancyScore: 0
IllustrationInfo
Items – Name: Title
  Label: Title
  Group: Ti
  Data: Racial, ethnic and neighborhood socioeconomic differences in incidence of dementia: A regional retrospective cohort study.
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Becerril%2C+Alissa%22">Becerril, Alissa</searchLink><br /><searchLink fieldCode="AR" term="%22Pfoh%2C+Elizabeth+R%2E%22">Pfoh, Elizabeth R.</searchLink><br /><searchLink fieldCode="AR" term="%22Hashmi%2C+Ardeshir+Z%2E%22">Hashmi, Ardeshir Z.</searchLink><br /><searchLink fieldCode="AR" term="%22Mourany%2C+Lyla%22">Mourany, Lyla</searchLink><br /><searchLink fieldCode="AR" term="%22Gunzler%2C+Douglas+D%2E%22">Gunzler, Douglas D.</searchLink><br /><searchLink fieldCode="AR" term="%22Berg%2C+Kristen+A%2E%22">Berg, Kristen A.</searchLink><br /><searchLink fieldCode="AR" term="%22Krieger%2C+Nikolas+I%2E%22">Krieger, Nikolas I.</searchLink><br /><searchLink fieldCode="AR" term="%22Krishnan%2C+Kamini%22">Krishnan, Kamini</searchLink><br /><searchLink fieldCode="AR" term="%22Moore%2C+Scott+Emory%22">Moore, Scott Emory</searchLink><br /><searchLink fieldCode="AR" term="%22Kahana%2C+Eva%22">Kahana, Eva</searchLink><br /><searchLink fieldCode="AR" term="%22Dawson%2C+Neal+V%2E%22">Dawson, Neal V.</searchLink><br /><searchLink fieldCode="AR" term="%22Luezas+Shamakian%2C+Lorella%22">Luezas Shamakian, Lorella</searchLink><br /><searchLink fieldCode="AR" term="%22Campbell%2C+James+W%2E%22">Campbell, James W.</searchLink><br /><searchLink fieldCode="AR" term="%22Perzynski%2C+Adam+T%2E%22">Perzynski, Adam T.</searchLink><br /><searchLink fieldCode="AR" term="%22Dalton%2C+Jarrod+E%2E%22">Dalton, Jarrod E.</searchLink>
– Name: TitleSource
  Label: Source
  Group: Src
  Data: <searchLink fieldCode="JN" term="%22Journal+of+the+American+Geriatrics+Society%22">Journal of the American Geriatrics Society</searchLink>. Aug2023, Vol. 71 Issue 8, p2406-2418. 13p.
– Name: Subject
  Label: Subjects
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Dementia+risk+factors%22">Dementia risk factors</searchLink><br /><searchLink fieldCode="DE" term="%22Confidence+intervals%22">Confidence intervals</searchLink><br /><searchLink fieldCode="DE" term="%22Race%22">Race</searchLink><br /><searchLink fieldCode="DE" term="%22Retrospective+studies%22">Retrospective studies</searchLink><br /><searchLink fieldCode="DE" term="%22Socioeconomic+factors%22">Socioeconomic factors</searchLink><br /><searchLink fieldCode="DE" term="%22Risk+assessment%22">Risk assessment</searchLink><br /><searchLink fieldCode="DE" term="%22Dementia%22">Dementia</searchLink><br /><searchLink fieldCode="DE" term="%22Descriptive+statistics%22">Descriptive statistics</searchLink><br /><searchLink fieldCode="DE" term="%22Factor+analysis%22">Factor analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Research+funding%22">Research funding</searchLink><br /><searchLink fieldCode="DE" term="%22Spatial+behavior%22">Spatial behavior</searchLink><br /><searchLink fieldCode="DE" term="%22Neighborhood+characteristics%22">Neighborhood characteristics</searchLink><br /><searchLink fieldCode="DE" term="%22Longitudinal+method%22">Longitudinal method</searchLink>
– Name: SubjectGeographic
  Label: Geographic Terms
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Ohio%22">Ohio</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background: Evidence on the effects of neighborhood socioeconomic disadvantage on dementia risk in racially and ethically diverse populations is limited. Our objective was to evaluate the relative extent to which neighborhood disadvantage accounts for racial/ethnic variation in dementia incidence rates. Secondarily, we evaluated the spatial relationship between neighborhood disadvantage and dementia risk. Methods: In this retrospective study using electronic health records (EHR) at two regional health systems in Northeast Ohio, participants included 253,421 patients aged >60 years who had an outpatient primary care visit between January 1, 2005 and December 31, 2015. The date of the first qualifying visit served as the study baseline. Cumulative incidence of composite dementia outcome, defined as EHR‐documented dementia diagnosis or dementia‐related death, stratified by neighborhood socioeconomic deprivation (as measured by Area Deprivation Index) was determined by competing‐risk regression analysis, with non‐dementia‐related death as the competing risk. Fine‐Gray sub‐distribution hazard ratios were determined for neighborhood socioeconomic deprivation, race/ethnicity, and clinical risk factors. The degree to which neighborhood socioeconomic position accounted for racial/ethnic disparities in the incidence of composite dementia outcome was evaluated via mediation analysis with Poisson rate models. Results: Increasing neighborhood disadvantage was associated with increased risk of EHR‐documented dementia diagnosis or dementia‐related death (most vs. least disadvantaged ADI quintile HR = 1.76, 95% confidence interval = 1.69–1.84) after adjusting for age and sex. The effect of neighborhood disadvantage on this composite dementia outcome remained after accounting for known medical risk factors of dementia. Mediation analysis indicated that neighborhood disadvantage accounted for 34% and 29% of the elevated risk for composite dementia outcome in Hispanic and Black patients compared to White patients, respectively. Conclusion: Neighborhood disadvantage is related to the risk of EHR‐documented dementia diagnosis or dementia‐related death and accounts for a portion of racial/ethnic differences in dementia burden, even after adjustment for clinically important confounders. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of Journal of the American Geriatrics Society is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=169783524
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1111/jgs.18322
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 13
        StartPage: 2406
    Subjects:
      – SubjectFull: Dementia risk factors
        Type: general
      – SubjectFull: Confidence intervals
        Type: general
      – SubjectFull: Race
        Type: general
      – SubjectFull: Retrospective studies
        Type: general
      – SubjectFull: Socioeconomic factors
        Type: general
      – SubjectFull: Risk assessment
        Type: general
      – SubjectFull: Dementia
        Type: general
      – SubjectFull: Descriptive statistics
        Type: general
      – SubjectFull: Factor analysis
        Type: general
      – SubjectFull: Research funding
        Type: general
      – SubjectFull: Spatial behavior
        Type: general
      – SubjectFull: Neighborhood characteristics
        Type: general
      – SubjectFull: Longitudinal method
        Type: general
      – SubjectFull: Ohio
        Type: general
    Titles:
      – TitleFull: Racial, ethnic and neighborhood socioeconomic differences in incidence of dementia: A regional retrospective cohort study.
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Becerril, Alissa
      – PersonEntity:
          Name:
            NameFull: Pfoh, Elizabeth R.
      – PersonEntity:
          Name:
            NameFull: Hashmi, Ardeshir Z.
      – PersonEntity:
          Name:
            NameFull: Mourany, Lyla
      – PersonEntity:
          Name:
            NameFull: Gunzler, Douglas D.
      – PersonEntity:
          Name:
            NameFull: Berg, Kristen A.
      – PersonEntity:
          Name:
            NameFull: Krieger, Nikolas I.
      – PersonEntity:
          Name:
            NameFull: Krishnan, Kamini
      – PersonEntity:
          Name:
            NameFull: Moore, Scott Emory
      – PersonEntity:
          Name:
            NameFull: Kahana, Eva
      – PersonEntity:
          Name:
            NameFull: Dawson, Neal V.
      – PersonEntity:
          Name:
            NameFull: Luezas Shamakian, Lorella
      – PersonEntity:
          Name:
            NameFull: Campbell, James W.
      – PersonEntity:
          Name:
            NameFull: Perzynski, Adam T.
      – PersonEntity:
          Name:
            NameFull: Dalton, Jarrod E.
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 08
              Text: Aug2023
              Type: published
              Y: 2023
          Identifiers:
            – Type: issn-print
              Value: 00028614
          Numbering:
            – Type: volume
              Value: 71
            – Type: issue
              Value: 8
          Titles:
            – TitleFull: Journal of the American Geriatrics Society
              Type: main
ResultId 1