For a study, researchers sought to assess dementia prevalence across five race and Ethnicity groups and by US geographical area in a large, varied national cohort of older veterans cared for in the country’s biggest integrated health care system. Retrospective cohort research conducted inside the Veterans Health Administration (VHA) of a random sample (5% sample selected for each fiscal year) of 1,869,090 individuals aged 55 or older from October 1, 1999 to September 30, 2019. (the date of final follow-up). The National Patient Care Database was used to acquire self-reported racial and ethnic data. The United States’ area was defined using the Centers for Disease Control and Prevention’s (CDC) regions based on residential zip codes. Dementia diagnosis on the spot (9th and 10th editions of the International Classification of Diseases). Fine-Gray proportional hazards models using age as the time scale and accounting for competing risk of mortality were used to investigate time to diagnosis.
Over a mean follow-up of 10.1 years, 13% of the 1,869,090 study participants (mean age, 69.4 [SD, 7.9]; 42,870 women [2%], 6,865 American Indian or Alaska Native [0.4%], 9,391 Asian [0.5], 176,795 Black [9.5%], 20,663 Hispanic [1.0%], and 1,655,376 White [88.6%] received a dementia diagnosis. The age-adjusted incidence of dementia per 1,000 person-years for American Indian or Alaska Native participants was 14.2 (95% CI, 13.3-15.1), 12.4 (95% CI, 11.7-13.1), 19.4 (95% CI, 19.2-19.6), 20.7 (95% CI, 20.1-21.3), and 11.5 (95% CI, 11.4-11.6) for White participants. The fully adjusted hazard ratios for American Indian or Alaska Native individuals were 1.05 (95% CI, 0.98-1.13), 1.20 (95% CI, 1.13-1.28), 1.54 (95% CI, 1.51-1.57), and 1.92 (95% CI, 1.82-2.02) when compared to White participants. Age-adjusted dementia incidence rates were greatest for Black and Hispanic individuals across most US areas, with rates comparable for American Indian or Alaska Native, Asian, and White people. There were substantial disparities in dementia incidence depending on race and ethnicity among older persons who got care at VHA medical centers. More study was required to understand the processes behind these disparities.
Reference:jamanetwork.com/journals/jama/article-abstract/2791223
