부산대학교 도서관

Keywords: dementia; diagnosis; disparities; older adults; race Abstract Background Non-Hispanic Black individuals may be less likely to receive a diagnosis of dementia compared to non-Hispanic White individuals. These findings raise important questions regarding which factors may explain this observed association and any differences in the time to which disparities emerge following dementia onset. Methods We conducted a retrospective cohort study using survey data from the 1995 to 2016 Health and Retirement Study linked with Medicare fee-for-service claims. Using the Hurd algorithm (a regression-based approach), we identified dementia onset among older adult respondents (age â¥65years) from the Telephone Interview for Cognitive Status and proxy respondents. We determined date from dementia onset to diagnosis using Medicare data up to 3years following onset using a list of established diagnosis codes. Cox Proportional Hazards modeling was used to examine the association between an individual's reported race and likelihood of diagnosis after accounting for sociodemographic characteristics, income, education, functional status, and healthcare use. Results We identified 3435 older adults who experienced a new onset of dementia. Among them, 30.1% received a diagnosis within 36months of onset. In unadjusted analyses, the difference in cumulative proportion diagnosed by race continued to increase across time following onset, p-value Conclusion Lower diagnosis rates of dementia among non-Hispanic Black individuals persists after adjustment for sociodemographic characteristics, functional status, and healthcare use. Further understanding of barriers to diagnosis that may be related to social determinants of health is needed to improve dementia-related outcomes among non-Hispanic Black Americans. Article Note: Funding information Institute for Social Research, University of Michigan, Ann Arbor, MI; National Institute on Aging, Grant/Award Numbers: P01 AG019783, P30 AG024824, P30 AG053760, P30 AG066582, R01 AG053972, U01 AG009740; U.S. Social Security Administration CAPTION(S): Table S1. Hazard ratios for the association between race and ADRD clinical diagnosis Byline: Matthew A. Davis, Kathryn A. Lee, Melissa Harris, Jinkyung Ha, Kenneth M. Langa, Julie P. W. Bynum, Geoffrey J. Hoffman