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  1. Article ; Online: Racial/Ethnic Disparities in Length of Life after Dementia Diagnosis

    Yi Chen / Eileen Crimmins / Patricia Ferido / Julie M. Zissimopoulos

    The Lancet Regional Health. Americas, Vol 8, Iss , Pp 100179- (2022)

    an 18-Year Follow-up Study of Medicare Beneficiaries

    2022  

    Abstract: Summary: Background: This study quantifies survival time after dementia diagnosis and assesses mechanisms driving differences across race/ethnicity to inform care and financial planning. Methods: Using 100% Medicare claims data, we identified 670,955 ... ...

    Abstract Summary: Background: This study quantifies survival time after dementia diagnosis and assesses mechanisms driving differences across race/ethnicity to inform care and financial planning. Methods: Using 100% Medicare claims data, we identified 670,955 beneficiaries with incident dementia diagnosis in 2001 and followed them through 2018. We quantified racial/ethnic differences in post-diagnosis survival and for subgroups defined by sex, age at diagnosis, socio-economic status, and geography. Additionally, we investigated racial/ethnic time trends in 5-year mortality risk of 8,080,098 beneficiaries with incident dementia in years 2001-2013. Findings: Hispanics and Asians diagnosed with dementia had 40% lower mortality risk and African Americans had 13% lower mortality risk than Whites. There was no difference between American Indians/Alaska Natives and Whites. Racial/ethnic differences were of similar size in sex, age at diagnosis, and urban/rural subgroups; however, the survival advantage between non-Whites and Whites was larger among low-income beneficiaries. State differences in mortality among Blacks were consistent with a Southern divide but not for Asians and Hispanics. The Asian-White and Hispanic-White mortality differences decreased 2001 to 2013. Interpretation: Racial/ethnic survival differences after dementia diagnosis have implications for magnitude of financial impact of dementia on individuals and families. Quantifying survival differences and changes over time informs family, community, and societal level long-term care planning for a large and growing population of persons living with dementia. Variation in the size of racial/ethnic differences by economic status and geographic location provides opportunities for targeted strategies to reduce economic consequences and improve care and quality of life after dementia diagnosis. Funding: National Institutes of Health (R01AG055401, P30AG066589).
    Keywords dementia ; racial/ethnic disparities ; mortality ; mechanisms ; Public aspects of medicine ; RA1-1270
    Subject code 360 ; 390
    Language English
    Publishing date 2022-04-01T00:00:00Z
    Publisher Elsevier
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Statin therapy and risk of Alzheimer's and age‐related neurodegenerative diseases

    Georgina Torrandell‐Haro / Gregory L. Branigan / Francesca Vitali / Nophar Geifman / Julie M. Zissimopoulos / Roberta Diaz Brinton

    Alzheimer’s & Dementia: Translational Research & Clinical Interventions, Vol 6, Iss 1, Pp n/a-n/a (2020)

    2020  

    Abstract: Abstract Introduction Establishing efficacy of and molecular pathways for statins has the potential to impact incidence of Alzheimer's and age‐related neurodegenerative diseases (NDD). Methods This retrospective cohort study surveyed US‐based Humana ... ...

    Abstract Abstract Introduction Establishing efficacy of and molecular pathways for statins has the potential to impact incidence of Alzheimer's and age‐related neurodegenerative diseases (NDD). Methods This retrospective cohort study surveyed US‐based Humana claims, which includes prescription and patient records from private‐payer and Medicare insurance. Claims from 288,515 patients, aged 45 years and older, without prior history of NDD or neurological surgery, were surveyed for a diagnosis of NDD starting 1 year following statin exposure. Patients were required to be enrolled with claims data for at least 6 months prior to first statin prescription and at least 3 years thereafter. Computational system biology analysis was conducted to determine unique target engagement for each statin. Results Of the 288,515 participants included in the study, 144,214 patients (mean [standard deviation (SD)] age, 67.22 [3.8] years) exposed to statin therapies, and 144,301 patients (65.97 [3.2] years) were not treated with statins. The mean (SD) follow‐up time was 5.1 (2.3) years. Exposure to statins was associated with a lower incidence of Alzheimer's disease (1.10% vs 2.37%; relative risk [RR], 0.4643; 95% confidence interval [CI], 0.44–0.49; P < .001), dementia 3.03% vs 5.39%; RR, 0.56; 95% CI, 0.54–0.58; P < .001), multiple sclerosis (0.08% vs 0.15%; RR, 0.52; 95% CI, 0.41–0.66; P < .001), Parkinson's disease (0.48% vs 0.92%; RR, 0.53; 95% CI, 0.48–0.58; P < .001), and amyotrophic lateral sclerosis (0.02% vs 0.05%; RR, 0.46; 95% CI, 0.30–0.69; P < .001). All NDD incidence for all statins, except for fluvastatin (RR, 0.91; 95% CI, 0.65‐1.30; P = 0.71), was reduced with variances in individual risk profiles. Pathway analysis indicated unique and common profiles associated with risk reduction efficacy. Discussion Benefits and risks of statins relative to neurological outcomes should be considered when prescribed for at‐risk NDD populations. Common statin activated pathways indicate overarching systems required for risk ...
    Keywords age ; Alzheimer's disease ; amyotrophic lateral sclerosis ; bioinformatics ; biology pathway analysis ; cholesterol ; Neurology. Diseases of the nervous system ; RC346-429 ; Geriatrics ; RC952-954.6
    Subject code 610
    Language English
    Publishing date 2020-01-01T00:00:00Z
    Publisher Wiley
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

    Full text online

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    Inter-library loan at ZB MED

    Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

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