Joshua L Paley, Grant D Scheiffele, Yujia Li, C Elizabeth Shaaban, Yonghui Wu, Stephen Anton, Steven DeKosky, Jiang Bian, Jingchuan Guo
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引用次数: 0
摘要
关于邻里剥夺在多大程度上影响阿尔茨海默病（AD）和AD相关痴呆（AD/ADRD）患者死亡率的量化研究有限。目的量化邻里剥夺对AD/ADRD患者不良结局的影响程度。方法：我们使用15%的国家医疗保险服务收费受益人随机样本确定AD/ADRD患者。区域剥夺指数（ADI）在空间上与使用邮政编码的Medicare AD/ADRD队列相关联。应用多变量逻辑回归来检验AD/ADRD受益人中ADI与全因死亡率之间的关系。结果在调整患者特征后，与最低ADI四分位数（Q1）相比，较高的ADI四分位数与AD/ADRD患者的全因死亡率相关（Q2 = OR 1.08 [95% CI: 1.06, 1.10], Q3 = OR 1.09 [95% CI: 1.07, 1.11], Q4 OR 1.05 [95% CI: 1.03, 1.07]）。结论邻里剥夺是AD/ADRD患者死亡的独立危险因素。
Neighborhood deprivation and mortality among people with Alzheimer's disease and related dementia.
BackgroundThere are limited studies quantifying the extent to which neighborhood deprivation affects mortality in individuals living with Alzheimer's disease (AD) and AD-related dementias (AD/ADRD).ObjectiveTo quantify to what extent neighborhood deprivation affects adverse outcomes in individuals living with AD/ADRD.MethodsWe identified individuals with AD/ADRD using a 15% random sample of national Medicare fee-for-service beneficiaries. Area deprivation index (ADI) was spatially linked to the Medicare AD/ADRD cohort using zip codes. Multivariate logistic regression was applied to examine the association between ADI and all-cause mortality among beneficiaries with AD/ADRD.ResultsAfter adjusting for patients characteristics, compared to the lowest ADI quartile (Q1), higher ADI quartiles were associated with higher odds of all-cause mortality in individuals with AD/ADRD (Q2 = OR 1.08 [95% CI: 1.06, 1.10], Q3 = OR 1.09 [95% CI: 1.07, 1.11], and Q4 OR 1.05 [95% CI: 1.03, 1.07]).ConclusionsNeighborhood deprivation is an independent risk factor for mortality in persons with AD/ADRD.
期刊介绍：
The Journal of Alzheimer''s Disease (JAD) is an international multidisciplinary journal to facilitate progress in understanding the etiology, pathogenesis, epidemiology, genetics, behavior, treatment and psychology of Alzheimer''s disease. The journal publishes research reports, reviews, short communications, hypotheses, ethics reviews, book reviews, and letters-to-the-editor. The journal is dedicated to providing an open forum for original research that will expedite our fundamental understanding of Alzheimer''s disease.
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