Anya Alag, Nicole A Nishimori, Lilia Kazerooni, Maeve C Lucas, David J Huh, Mariam M Yousuf, Saba Jafarpour, Cathy Franklin, Eileen A Quinn, Jonathan D Santoro
{"title":"照顾者感知唐氏综合症退行性障碍的诊断和护理障碍。","authors":"Anya Alag, Nicole A Nishimori, Lilia Kazerooni, Maeve C Lucas, David J Huh, Mariam M Yousuf, Saba Jafarpour, Cathy Franklin, Eileen A Quinn, Jonathan D Santoro","doi":"10.1002/ajmg.a.64274","DOIUrl":null,"url":null,"abstract":"<p><p>Down Syndrome Regression Disorder (DSRD) is a rare neuropsychiatric condition affecting individuals with Trisomy 21. Barriers to care for DSRD patients have not been studied. This research aimed to explore how demographic, socioeconomic, and geographic factors influence access to diagnosis, testing, and treatment for individuals with DSRD. A cross-sectional, online, REDCap survey was utilized to query caregivers of individuals with DSRD. Eligible caregivers answered questions regarding demographics, clinical features, and barriers to diagnosis and treatment. Statistical analysis was performed using R software, employing χ<sup>2</sup>, Mann-Whitney U, and Kruskal-Wallis H tests. A total of 397 participants were enrolled, most from the US (74%). Barriers to diagnosis (58.1%), treatment (52.6%), referral (52.0%), and testing (39.4%) were prevalent. Key barriers included physician unfamiliarity with DSRD and a lack of local specialists. Travel distances for diagnosis, testing, and treatment were significant, with 14.7% traveling over 500 miles for diagnosis and some requiring international travel. Factors influencing delays in diagnosis and treatment included household income, region, and demographic variables. Higher income was associated with shorter time to diagnosis (p = 0.004) and treatment (p < 0.001). Race, income, maternal education, and setting influenced delays in diagnosis. Delays in treatment were influenced by ethnicity, income, and location. This large international survey of caregivers of individuals with DSRD elucidates perceived barriers to accessing diagnosis, testing, and treatment, with demographic factors such as socioeconomic status and geography influencing these challenges. The directionality of these effects and their impact on clinical care and outcomes will be a logical basis for additional studies. Further studies are needed to explore these barriers in greater depth and assess their impact on healthcare outcomes.</p>","PeriodicalId":7507,"journal":{"name":"American Journal of Medical Genetics Part A","volume":" ","pages":"e64274"},"PeriodicalIF":1.7000,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Caregiver Perceived Barriers to Diagnosis and Care in Down Syndrome Regression Disorder.\",\"authors\":\"Anya Alag, Nicole A Nishimori, Lilia Kazerooni, Maeve C Lucas, David J Huh, Mariam M Yousuf, Saba Jafarpour, Cathy Franklin, Eileen A Quinn, Jonathan D Santoro\",\"doi\":\"10.1002/ajmg.a.64274\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Down Syndrome Regression Disorder (DSRD) is a rare neuropsychiatric condition affecting individuals with Trisomy 21. Barriers to care for DSRD patients have not been studied. This research aimed to explore how demographic, socioeconomic, and geographic factors influence access to diagnosis, testing, and treatment for individuals with DSRD. A cross-sectional, online, REDCap survey was utilized to query caregivers of individuals with DSRD. Eligible caregivers answered questions regarding demographics, clinical features, and barriers to diagnosis and treatment. Statistical analysis was performed using R software, employing χ<sup>2</sup>, Mann-Whitney U, and Kruskal-Wallis H tests. A total of 397 participants were enrolled, most from the US (74%). Barriers to diagnosis (58.1%), treatment (52.6%), referral (52.0%), and testing (39.4%) were prevalent. Key barriers included physician unfamiliarity with DSRD and a lack of local specialists. Travel distances for diagnosis, testing, and treatment were significant, with 14.7% traveling over 500 miles for diagnosis and some requiring international travel. Factors influencing delays in diagnosis and treatment included household income, region, and demographic variables. Higher income was associated with shorter time to diagnosis (p = 0.004) and treatment (p < 0.001). Race, income, maternal education, and setting influenced delays in diagnosis. Delays in treatment were influenced by ethnicity, income, and location. This large international survey of caregivers of individuals with DSRD elucidates perceived barriers to accessing diagnosis, testing, and treatment, with demographic factors such as socioeconomic status and geography influencing these challenges. The directionality of these effects and their impact on clinical care and outcomes will be a logical basis for additional studies. Further studies are needed to explore these barriers in greater depth and assess their impact on healthcare outcomes.</p>\",\"PeriodicalId\":7507,\"journal\":{\"name\":\"American Journal of Medical Genetics Part A\",\"volume\":\" \",\"pages\":\"e64274\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2025-10-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American Journal of Medical Genetics Part A\",\"FirstCategoryId\":\"99\",\"ListUrlMain\":\"https://doi.org/10.1002/ajmg.a.64274\",\"RegionNum\":4,\"RegionCategory\":\"生物学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"GENETICS & HEREDITY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Medical Genetics Part A","FirstCategoryId":"99","ListUrlMain":"https://doi.org/10.1002/ajmg.a.64274","RegionNum":4,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"GENETICS & HEREDITY","Score":null,"Total":0}
Caregiver Perceived Barriers to Diagnosis and Care in Down Syndrome Regression Disorder.
Down Syndrome Regression Disorder (DSRD) is a rare neuropsychiatric condition affecting individuals with Trisomy 21. Barriers to care for DSRD patients have not been studied. This research aimed to explore how demographic, socioeconomic, and geographic factors influence access to diagnosis, testing, and treatment for individuals with DSRD. A cross-sectional, online, REDCap survey was utilized to query caregivers of individuals with DSRD. Eligible caregivers answered questions regarding demographics, clinical features, and barriers to diagnosis and treatment. Statistical analysis was performed using R software, employing χ2, Mann-Whitney U, and Kruskal-Wallis H tests. A total of 397 participants were enrolled, most from the US (74%). Barriers to diagnosis (58.1%), treatment (52.6%), referral (52.0%), and testing (39.4%) were prevalent. Key barriers included physician unfamiliarity with DSRD and a lack of local specialists. Travel distances for diagnosis, testing, and treatment were significant, with 14.7% traveling over 500 miles for diagnosis and some requiring international travel. Factors influencing delays in diagnosis and treatment included household income, region, and demographic variables. Higher income was associated with shorter time to diagnosis (p = 0.004) and treatment (p < 0.001). Race, income, maternal education, and setting influenced delays in diagnosis. Delays in treatment were influenced by ethnicity, income, and location. This large international survey of caregivers of individuals with DSRD elucidates perceived barriers to accessing diagnosis, testing, and treatment, with demographic factors such as socioeconomic status and geography influencing these challenges. The directionality of these effects and their impact on clinical care and outcomes will be a logical basis for additional studies. Further studies are needed to explore these barriers in greater depth and assess their impact on healthcare outcomes.
期刊介绍:
The American Journal of Medical Genetics - Part A (AJMG) gives you continuous coverage of all biological and medical aspects of genetic disorders and birth defects, as well as in-depth documentation of phenotype analysis within the current context of genotype/phenotype correlations. In addition to Part A , AJMG also publishes two other parts:
Part B: Neuropsychiatric Genetics , covering experimental and clinical investigations of the genetic mechanisms underlying neurologic and psychiatric disorders.
Part C: Seminars in Medical Genetics , guest-edited collections of thematic reviews of topical interest to the readership of AJMG .