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Alzheimers Dement. 2016 Mar;12(3):216-24. doi: 10.1016/j.jalz.2015.12.007. Epub 2016 Feb 11.

Inequalities in dementia incidence between six racial and ethnic groups over 14 years.

Author information

1
Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA.
2
Kaiser Permanente Division of Research, Oakland, CA, USA.
3
Kaiser Permanente Division of Research, Oakland, CA, USA; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA. Electronic address: Rachel.Whitmer@kp.org.

Abstract

INTRODUCTION:

Reducing racial/ethnic disparities is a primary objective of the National Alzheimer's Plan (NAPA), yet direct comparisons within large samples representing diversity of the United States are lacking.

METHODS:

Dementia incidence from January 1, 2000 to December 31, 2013 and a 25-year cumulative risk in 274,283 health care members aged 64+ (n = 18,778 African-American, n = 4543 American Indian/Alaska Native [AIAN], n = 21,000 Latino, n = 440 Pacific Islander, n = 206,490 white, n = 23,032 Asian-Americans). Cox proportional hazard models were adjusted for age, sex, medical utilization, and comorbidities.

RESULTS:

Dementia incidence (n = 59,555) was highest for African-Americans (26.6/1000 person-years) and AIANs (22.2/1000 person-years); intermediate for Latinos (19.6/1000 person-years), Pacific Islanders (19.6/1000 person-years), and whites (19.3/1000 person-years) and lowest among Asian-Americans (15.2/1000 person-years). Risk was 65% greater for African-Americans (hazard ratio = 1.65; 95% confidence interval = 1.58-1.72) versus Asian-Americans. Cumulative 25-year risk at age 65 was as follows: 38% African-Americans, 35% AIANs, 32% Latino, 25% Pacific Islanders, 30% white, and 28% Asian-Americans.

DISCUSSION:

Dementia rates varied over 60% between groups, providing a comprehensive benchmark for the NAPA goal of reducing disparities.

KEYWORDS:

Cohort; Dementia; Disparities; Epidemiology; Ethnicity; Race

PMID:
26874595
PMCID:
PMC4969071
[Available on 2017-03-01]
DOI:
10.1016/j.jalz.2015.12.007
[Indexed for MEDLINE]
Free PMC Article

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