1
|
2024 Alzheimer's disease facts and figures. Alzheimers Dement 2024; 20:3708-3821. [PMID: 38689398 PMCID: PMC11095490 DOI: 10.1002/alz.13809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
This article describes the public health impact of Alzheimer's disease (AD), including prevalence and incidence, mortality and morbidity, use and costs of care and the ramifications of AD for family caregivers, the dementia workforce and society. The Special Report discusses the larger health care system for older adults with cognitive issues, focusing on the role of caregivers and non-physician health care professionals. An estimated 6.9 million Americans age 65 and older are living with Alzheimer's dementia today. This number could grow to 13.8 million by 2060, barring the development of medical breakthroughs to prevent or cure AD. Official AD death certificates recorded 119,399 deaths from AD in 2021. In 2020 and 2021, when COVID-19 entered the ranks of the top ten causes of death, Alzheimer's was the seventh-leading cause of death in the United States. Official counts for more recent years are still being compiled. Alzheimer's remains the fifth-leading cause of death among Americans age 65 and older. Between 2000 and 2021, deaths from stroke, heart disease and HIV decreased, whereas reported deaths from AD increased more than 140%. More than 11 million family members and other unpaid caregivers provided an estimated 18.4 billion hours of care to people with Alzheimer's or other dementias in 2023. These figures reflect a decline in the number of caregivers compared with a decade earlier, as well as an increase in the amount of care provided by each remaining caregiver. Unpaid dementia caregiving was valued at $346.6 billion in 2023. Its costs, however, extend to unpaid caregivers' increased risk for emotional distress and negative mental and physical health outcomes. Members of the paid health care and broader community-based workforce are involved in diagnosing, treating and caring for people with dementia. However, the United States faces growing shortages across different segments of the dementia care workforce due to a combination of factors, including the absolute increase in the number of people living with dementia. Therefore, targeted programs and care delivery models will be needed to attract, better train and effectively deploy health care and community-based workers to provide dementia care. Average per-person Medicare payments for services to beneficiaries age 65 and older with AD or other dementias are almost three times as great as payments for beneficiaries without these conditions, and Medicaid payments are more than 22 times as great. Total payments in 2024 for health care, long-term care and hospice services for people age 65 and older with dementia are estimated to be $360 billion. The Special Report investigates how caregivers of older adults with cognitive issues interact with the health care system and examines the role non-physician health care professionals play in facilitating clinical care and access to community-based services and supports. It includes surveys of caregivers and health care workers, focusing on their experiences, challenges, awareness and perceptions of dementia care navigation.
Collapse
|
2
|
Voigt RM, Ouyang B, Keshavarzian A. Outdoor Nighttime Light Exposure (Light Pollution) is Associated with Alzheimer's Disease. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.02.14.24302831. [PMID: 38405987 PMCID: PMC10889016 DOI: 10.1101/2024.02.14.24302831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
Alzheimer's disease (AD) prevalence has increased in the last century which can be attributed to increased lifespan, but environment is also important. This study evaluated the relationship between outdoor nighttime light exposure and AD prevalence in the United States. Higher outdoor nighttime light was associated with higher prevalence of AD. While atrial fibrillation, diabetes, hyperlipidemia, hypertension, and stroke were associated more strongly with AD prevalence than nighttime light intensity, nighttime light was more strongly associated with AD prevalence than alcohol abuse, chronic kidney disease, depression, heart failure, and obesity. Startlingly, nighttime light exposure more strongly associated with AD prevalence in those under the age of 65 than any other disease factor examined. These data indicate a need to investigate how nighttime light exposure influences AD pathogenesis.
Collapse
Affiliation(s)
- Robin M Voigt
- Rush Medical College, Rush Center for Integrated Microbiome and Chronobiology Research, Rush University Medical Center; Chicago, IL, USA
- Department of Internal Medicine, Rush University Medical Center; Chicago, IL, USA
- Department of Anatomy & Cell Biology, Rush University Medical Center; Chicago, IL, USA
| | - Bichun Ouyang
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Ali Keshavarzian
- Rush Medical College, Rush Center for Integrated Microbiome and Chronobiology Research, Rush University Medical Center; Chicago, IL, USA
- Department of Internal Medicine, Rush University Medical Center; Chicago, IL, USA
- Department of Anatomy & Cell Biology, Rush University Medical Center; Chicago, IL, USA
- Department of Physiology, Rush University Medical Center, Chicago, IL, USA
| |
Collapse
|
3
|
Kindratt TB, Ajrouch KJ, Zahodne LB, Dallo FJ. Suspected Undiagnosed ADRD Among Middle Eastern and North African Americans. J Immigr Minor Health 2023; 25:1098-1107. [PMID: 37351736 PMCID: PMC10527952 DOI: 10.1007/s10903-023-01509-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2023] [Indexed: 06/24/2023]
Abstract
ADRD underdiagnosis among minority populations is well-established and known to be more prevalent among women. Yet, it remains unclear if these patterns exist among adults of Middle Eastern and North African (MENA) descent. We estimated ADRD underdiagnosis among adults of MENA descent and other US- and foreign-born non-Hispanic Whites and compared sex-stratified results. We linked 2000-2017 National Health Interview Survey and 2001-2018 Medical Expenditure Panel Survey data (ages > = 65 years, n = 23,981). Undiagnosed ADRD was suspected if participants reported cognitive limitations without corresponding ADRD diagnosis. Undiagnosed ADRD was highest among adults of MENA descent (15.8%) compared to non-Hispanic Whites (US-born = 8.1%; foreign-born = 11.8%). Women of MENA descent had 2.52 times greater odds (95% CI = 1.31-4.84) of undiagnosed ADRD compared to US-born White women after adjusting for risk factors. This study contributes the first national estimates of undiagnosed ADRD among adults of MENA descent. Continued research is needed to facilitate policy changes that more comprehensively address health disparities and related resource allocation.
Collapse
Affiliation(s)
- Tiffany B Kindratt
- Public Health Program, Department of Kinesiology, College of Nursing and Health Innovation, University of Texas at Arlington, 500 West Nedderman Drive, Arlington, TX, 76019, USA.
| | - Kristine J Ajrouch
- Department of Sociology, Anthropology and Criminology, Eastern Michigan University, 712 Pray-Harrold, Ypsilanti, MI, 48197, USA
- Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI, 48104, USA
| | - Laura B Zahodne
- Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI, 48104, USA
- Department of Psychology, University of Michigan, 530 Church St., Ann Arbor, MI, 48109, USA
| | - Florence J Dallo
- School of Health Sciences, Oakland University, Rochester, MI, 48309-4452, USA
| |
Collapse
|
4
|
Kindratt TB, Ajrouch KJ, Zahodne LB, Dallo FJ. Suspected undiagnosed ADRD among Middle Eastern and North African Americans. RESEARCH SQUARE 2023:rs.3.rs-1983254. [PMID: 36993201 PMCID: PMC10055530 DOI: 10.21203/rs.3.rs-1983254/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
Abstract
Background ADRD underdiagnosis among minority populations is well-established and known to be more prevalent among women. Yet, it remains unclear if these patterns exist among Middle Eastern and North African (MENA) adults. We estimated ADRD underdiagnosis among MENA and other US- and foreign-born non-Hispanic Whites and compared sex-stratified results. Methods We linked 2000-2017 National Health Interview Survey and 2001-2018 Medical Expenditure Panel Survey data (ages > = 65 years, n = 23,981). Undiagnosed ADRD was suspected if participants reported cognitive limitations without corresponding ADRD diagnosis. Results Undiagnosed ADRD was highest among MENA adults (15.8%) compared to non-Hispanic Whites (US-born = 8.1%; foreign-born = 11.8%). MENA women had 2.52 times greater odds (95% CI = 1.31-4.84) of undiagnosed ADRD compared to US-born White women after adjusting for risk factors. Discussion This study contributes the first national estimates of undiagnosed ADRD among MENA adults. Continued research is needed to facilitate policy changes that more comprehensively address health disparities and related resource allocation.
Collapse
|
5
|
Abstract
This article describes the public health impact of Alzheimer's disease, including prevalence and incidence, mortality and morbidity, use and costs of care, and the overall impact on family caregivers, the dementia workforce and society. The Special Report examines the patient journey from awareness of cognitive changes to potential treatment with drugs that change the underlying biology of Alzheimer's. An estimated 6.7 million Americans age 65 and older are living with Alzheimer's dementia today. This number could grow to 13.8 million by 2060 barring the development of medical breakthroughs to prevent, slow or cure AD. Official death certificates recorded 121,499 deaths from AD in 2019, and Alzheimer's disease was officially listed as the sixth-leading cause of death in the United States. In 2020 and 2021, when COVID-19 entered the ranks of the top ten causes of death, Alzheimer's was the seventh-leading cause of death. Alzheimer's remains the fifth-leading cause of death among Americans age 65 and older. Between 2000 and 2019, deaths from stroke, heart disease and HIV decreased, whereas reported deaths from AD increased more than 145%. This trajectory of deaths from AD was likely exacerbated by the COVID-19 pandemic in 2020 and 2021. More than 11 million family members and other unpaid caregivers provided an estimated 18 billion hours of care to people with Alzheimer's or other dementias in 2022. These figures reflect a decline in the number of caregivers compared with a decade earlier, as well as an increase in the amount of care provided by each remaining caregiver. Unpaid dementia caregiving was valued at $339.5 billion in 2022. Its costs, however, extend to family caregivers' increased risk for emotional distress and negative mental and physical health outcomes - costs that have been aggravated by COVID-19. Members of the paid health care workforce are involved in diagnosing, treating and caring for people with dementia. In recent years, however, a shortage of such workers has developed in the United States. This shortage - brought about, in part, by COVID-19 - has occurred at a time when more members of the dementia care workforce are needed. Therefore, programs will be needed to attract workers and better train health care teams. Average per-person Medicare payments for services to beneficiaries age 65 and older with AD or other dementias are almost three times as great as payments for beneficiaries without these conditions, and Medicaid payments are more than 22 times as great. Total payments in 2023 for health care, long-term care and hospice services for people age 65 and older with dementia are estimated to be $345 billion. The Special Report examines whether there will be sufficient numbers of physician specialists to provide Alzheimer's care and treatment now that two drugs are available that change the underlying biology of Alzheimer's disease.
Collapse
|
6
|
Al-Rousan T, Kamalyan L, Bernstein Sideman A, Miller B, AlHeresh R, Moore A, Marquine MJ, Argeros G, Ajrouch KJ. Migration and Cognitive Health Disparities: The Arab American and Refugee Case. J Gerontol B Psychol Sci Soc Sci 2023; 78:111-123. [PMID: 36056890 PMCID: PMC9890904 DOI: 10.1093/geronb/gbac129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES This study investigates whether the year of arrival to the United States (U.S.) and birthplace relate to postmigration cognitive difficulties among foreign- and U.S.-born Arab Americans in later life. METHODS We analyzed 19 years (2000-2019) of data from the American Community Survey Public Use Microdata Samples (weighted N = 393,501; ages ≥ 50 years). Cognitive difficulty was based on self-reported data, and weighted means, percentages, adjusted prevalence estimates, and adjusted odds ratio were calculated. RESULTS Controlling only for demographics, foreign-born Arabs reported higher odds of cognitive difficulty compared to U.S.-born Arabs across all arrival cohorts (p < .001). After accounting for economic and integration factors, those who arrived between 1991 and 2000 had higher odds (odds ratio [OR] = 1.06, 95% confidence interval [CI] =1.00, 1.19, p < .01), while those who arrived after 2001 had lower odds (OR = 0.87, 95% CI = 0.78, 0.97, p < .001) of cognitive difficulty. Lacking English proficiency (OR = 1.90, 95% CI = 1.82, 1.98, p < .001) was related to higher odds, whereas not being a U.S. citizen was significantly associated with lower odds (OR = 0.89, 95% CI = 0.52, 0.94, p < .001) of cognitive difficulty. Yet, results varied by birthplace. Migrants born in Iraq consistently reported the highest odds of cognitive difficulty across all arrival cohorts. DISCUSSION Migration history and birthplace may be important factors explaining cognitive disparities among the diverse group of Arab migrants and Arab Americans. Future research examining mechanisms underlying these associations and the impact of migration on cognitive health is needed to address cognitive disparities in migrants.
Collapse
Affiliation(s)
- Tala Al-Rousan
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
- Global Brain Health Institute, University of California, San Francisco, California, USA
| | - Lily Kamalyan
- Department of Psychiatry, HIV Neurobehavioral Research Program, University of California, San Diego, California, USA
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA
| | - Alissa Bernstein Sideman
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, California, USA
- Department of Humanities and Social Sciences, University of California, San Francisco, San Francisco, California, USA
| | - Bruce Miller
- Global Brain Health Institute, University of California, San Francisco, California, USA
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, California, USA
| | - Rawan AlHeresh
- Mass General Health Institute of Health Professions, Boston, Massachusetts, USA
| | - Alison Moore
- Division of Geriatrics, Gerontology and Palliative Care, Department of Medicine, University of California, San Diego, California, USA
| | - María J Marquine
- Division of Geriatrics, Gerontology and Palliative Care, Department of Medicine, University of California, San Diego, California, USA
| | - Grigoris Argeros
- Department of Sociology, Anthropology, and Criminology, Eastern Michigan University, Ypsilanti, Michigan, USA
| | - Kristine J Ajrouch
- Department of Sociology, Anthropology, and Criminology, Eastern Michigan University, Ypsilanti, Michigan, USA
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| |
Collapse
|
7
|
Kindratt TB, Dallo FJ, Zahodne LB, Ajrouch KJ. Cognitive Limitations Among Middle Eastern and North African Immigrants. J Aging Health 2022; 34:1244-1253. [PMID: 35606926 PMCID: PMC9633450 DOI: 10.1177/08982643221103712] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To estimate and compare the prevalence of cognitive limitations among Middle Eastern and North African (MENA) immigrants compared to US- and foreign-born non-Hispanic Whites from Europe (including Russia/former USSR) and examine differences after controlling for risk factors. METHODS Cross-sectional data using linked 2000-2017 National Health Interview Survey and 2001-2018 Medical Expenditure Panel Survey data (ages >=65 years, n = 24,827) were analyzed. RESULTS The prevalence of cognitive limitations was 17.3% among MENA immigrants compared to 9.6% and 13.6% among US- and foreign-born non-Hispanic Whites from Europe. MENA immigrants had higher odds (OR = 1.88; 95% CI = 1.06-3.34) of reporting a cognitive limitation than US-born non-Hispanic Whites after controlling for age, sex, education, hearing loss, hypertension, depression, social isolation, and diabetes. DISCUSSION To further examine cognitive health among the MENA aging population, policy changes are needed to identify this group that is often absent from research because of their federal classification as non-Hispanic Whites.
Collapse
Affiliation(s)
- Tiffany B. Kindratt
- Public Health Program, Department of Kinesiology, College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX, USA
| | - Florence J. Dallo
- Department of Public and Environmental Wellness, School of Health Sciences, Oakland University, Rochester, MI, USA
| | - Laura B. Zahodne
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Kristine J. Ajrouch
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
- Department of Sociology, Anthropology and Criminology, Eastern Michigan University, Ypsilanti, MI, USA
| |
Collapse
|
8
|
Kindratt TB, Dallo FJ, Zahodne LB. Cognitive Disability Among Arab Americans by Nativity Status and Arrival Year: Lack of Evidence for the Healthy Migrant Effect. J Racial Ethn Health Disparities 2022; 9:2056-2062. [PMID: 34505264 PMCID: PMC8904646 DOI: 10.1007/s40615-021-01144-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 09/01/2021] [Accepted: 09/02/2021] [Indexed: 10/20/2022]
Abstract
Limited research exists on cognitive disabilities among Arab Americans, especially as it relates to arrival year among the foreign-born. The objectives of this study were to estimate the age- and sex-adjusted prevalence and associations of cognitive disability by (1) nativity status and (2) arrival year (pre-1991, 1991-2000, 2001-2013, and 2014-2018). We analyzed 11 years (2008-2018) of data from the American Community Survey (ACS) Public Use Microdata Samples (weighted n = 264,086; ages ≥ 45 years). Weighted means, percentages, age- and sex-adjusted prevalence estimates, and logistic regression results (crude and adjusted) were calculated. Among all Arab Americans, the age- and sex-adjusted prevalence of cognitive disability was 6.5%. The prevalence was lower for US-born (4.0%) compared to foreign-born (6.0%) (p-value < 0.0001). In logistic regression results, foreign-born Arab Americans were more likely to have a cognitive disability compared to US-born Arab Americans after adjusting for age and sex (OR = 1.41; 95% CI = 1.24, 1.61). Among foreign-born, Arab Americans arriving in 2014 or later had a lower prevalence of cognitive disability (3.4%) compared to all other arrival years at approximately 4.7%. With those arriving prior to 1991 as the reference category, those arriving between 1991 and 2000 were more likely to report a cognitive disability (OR = 1.05; 95% CI = 1.00, 1.08). However, those arriving between 2014 and 2018 were less likely to report a cognitive disability (OR = 0.81; 95% CI = 0.73, 0.88). These findings challenge the universality of the "healthy migrant effect" and highlight the relevance of socioeconomic disparities for Arab American cognitive health.
Collapse
Affiliation(s)
- Tiffany B Kindratt
- Public Health Program, Department of Kinesiology, College of Nursing and Health Innovation, University of Texas At Arlington, Arlington, TX, 76013, USA
| | - Florence J Dallo
- Department of Public and Environmental Wellness, School of Health Sciences, Oakland University, Rochester, MI, 48309-4452, USA.
| | - Laura B Zahodne
- Department of Psychology, University of Michigan, Ann Arbor, MI, 48109, USA
| |
Collapse
|
9
|
Abstract
This article describes the public health impact of Alzheimer's disease (AD), including incidence and prevalence, mortality and morbidity, use and costs of care, and the overall impact on family caregivers, the dementia workforce and society. The Special Report discusses consumers' and primary care physicians' perspectives on awareness, diagnosis and treatment of mild cognitive impairment (MCI), including MCI due to Alzheimer's disease. An estimated 6.5 million Americans age 65 and older are living with Alzheimer's dementia today. This number could grow to 13.8 million by 2060 barring the development of medical breakthroughs to prevent, slow or cure AD. Official death certificates recorded 121,499 deaths from AD in 2019, the latest year for which data are available. Alzheimer's disease was officially listed as the sixth-leading cause of death in the United States in 2019 and the seventh-leading cause of death in 2020 and 2021, when COVID-19 entered the ranks of the top ten causes of death. Alzheimer's remains the fifth-leading cause of death among Americans age 65 and older. Between 2000 and 2019, deaths from stroke, heart disease and HIV decreased, whereas reported deaths from AD increased more than 145%. More than 11 million family members and other unpaid caregivers provided an estimated 16 billion hours of care to people with Alzheimer's or other dementias in 2021. These figures reflect a decline in the number of caregivers compared with a decade earlier, as well as an increase in the amount of care provided by each remaining caregiver. Unpaid dementia caregiving was valued at $271.6 billion in 2021. Its costs, however, extend to family caregivers' increased risk for emotional distress and negative mental and physical health outcomes - costs that have been aggravated by COVID-19. Members of the dementia care workforce have also been affected by COVID-19. As essential care workers, some have opted to change jobs to protect their own health and the health of their families. However, this occurs at a time when more members of the dementia care workforce are needed. Average per-person Medicare payments for services to beneficiaries age 65 and older with AD or other dementias are almost three times as great as payments for beneficiaries without these conditions, and Medicaid payments are more than 22 times as great. Total payments in 2022 for health care, long-term care and hospice services for people age 65 and older with dementia are estimated to be $321 billion. A recent survey commissioned by the Alzheimer's Association revealed several barriers to consumers' understanding of MCI. The survey showed low awareness of MCI among Americans, a reluctance among Americans to see their doctor after noticing MCI symptoms, and persistent challenges for primary care physicians in diagnosing MCI. Survey results indicate the need to improve MCI awareness and diagnosis, especially in underserved communities, and to encourage greater participation in MCI-related clinical trials.
Collapse
|
10
|
Alkeridy WA, Al Khalifah RA, Mohammedin AS, Khallaf R, Muayqil T, Bucks RS. The Arabic Translation and Cross-Cultural Adaptation of the Bristol Activity of Daily Living Scale. J Alzheimers Dis 2022; 86:1123-1130. [PMID: 35147542 DOI: 10.3233/jad-215489] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND There are few Arabic language functional scales for patients with dementia. The Bristol Activity of Daily Living Scale (BADLS) was designed and validated for use in patients with dementia. OBJECTIVE Our study aimed to translate, cross-culturally adapt, and validate the BADLS to the Arabic language for people with neurocognitive decline and dementia. METHODS The original BADLS scale was translated to the Arabic language followed by face validity assessment through a pilot testing in five Arabic countries. The Arabic BADLS was assessed in a sample of 139 participants and their caregivers for concurrent and convergent validity. RESULTS The Arabic BADLS had excellent internal consistency, Cronbach's alpha 0.95 (95% CI 0.93-0.96). Likewise, the Arabic BADLS had strong convergent validity with the Montreal Cognitive Assessment (r = -0.82, p < 0.001). CONCLUSION The Arabic BADLS is a valid scale that can used to assess the functional performance of people living with dementia.
Collapse
Affiliation(s)
- Walid A Alkeridy
- Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.,Department of Medicine, Geriatric Division, University of British Columbia, Vancouver, Canada
| | | | - Ahmed S Mohammedin
- Imam Abdulrahman Bin Faisal University, Dammam, Medicine Department Geriatrics Division, Dammam, Saudi Arabia.,Ain Shams University, Geriatrics Department, Cairo, Egypt
| | - Roaa Khallaf
- King Fahad Specialist Hospital Dammam, Department of Medicine, Neurology Division, Dammam, Saudi Arabia
| | - Taim Muayqil
- Neurology Unit, Department of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Romola S Bucks
- School of Psychological Science & School of Population and Global Health, University of Western Australia, Perth, Australia
| |
Collapse
|
11
|
Read JG, Lynch SM, West JS. Disaggregating Heterogeneity among Non-Hispanic Whites: Evidence and Implications for U.S. Racial/Ethnic Health Disparities. POPULATION RESEARCH AND POLICY REVIEW 2021; 40:9-31. [PMID: 34898768 DOI: 10.1007/s11113-020-09632-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Research has made strides in disaggregating health data among racial/ethnic minorities, but less is known about the extent of diversity among Whites. Using logistic regression modeling applied to data on respondents aged 40+ from the 2008 to 2016 American Community Survey, we disaggregated the non-Hispanic White population by ancestry and other racial/ethnic groups (non-Hispanic Black, non-Hispanic Asian, and Hispanic) by common subgroupings and examined heterogeneity in disability. Using logistic regression models predicting six health outcome measures, we compared the spread of coefficients for each of the large racial/ethnic groups and all subgroupings within these large categories. The results revealed that health disparities within the White population are almost as large as disparities within other racial groups. In fact, when Whites were disaggregated by ancestry, mean health appeared to be more varied among Whites than between Whites and members of other racial/ethnic groups in many cases. Compositional changes in the ancestry of Whites, particularly declines in Whites of western European ancestry and increases in Whites of eastern European and Middle Eastern ancestry, contribute to this diversity. Together, these findings challenge the oft-assumed notion that Whites are a homogeneous group and indicate that the aggregate White category obscures substantial intra-ethnic heterogeneity in health.
Collapse
Affiliation(s)
- Jen'nan Ghazal Read
- Department of Sociology, Global Health Institute, Duke University, 417 Chapel Drive, Durham, NC 27708, USA
| | - Scott M Lynch
- Department of Sociology, Duke University, Durham, NC, USA
| | - Jessica S West
- Department of Sociology, Duke University, Durham, NC, USA
| |
Collapse
|
12
|
Dallo FJ, Kindratt TB, Zahodne L. Prevalence of Self-reported Cognitive Impairment Among Arab American Immigrants in the United States. Innov Aging 2021; 5:igaa058. [PMID: 33442566 PMCID: PMC7788314 DOI: 10.1093/geroni/igaa058] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Indexed: 11/28/2022] Open
Abstract
Background and Objectives Studies evaluating self-reported cognitive impairment among Arab American immigrants have not been conducted. Our objective was 2-fold: (a) to estimate and compare the age- and sex-adjusted prevalence of self-reported cognitive impairment between Arab American immigrants and U.S.- and immigrant non-Hispanic Whites, non-Hispanic Blacks, Hispanics and non-Hispanic Asians and (b) to examine associations between race, ethnicity, nativity status, and cognitive impairment among Arab American immigrants and non-Hispanic Whites (U.S.- and foreign-born) after controlling for explanatory factors. Research Design and Methods We used 18 years (2000–2017) of National Health Interview Survey data (n = 228 985; ages ≥ 45 years). Weighted percentages, prevalence estimates, and multivariable logistic regression models were calculated. Results The age- and sex-adjusted prevalence of self-reported cognitive impairment was significantly higher among Arab American immigrants (9.7%) compared to U.S.-born and non-Hispanic White immigrants (~7.4%). Discussion and Implications This is the first study to indicate that ethnic disparities in self-reported cognitive impairment may extend to Arab American immigrants. Additional studies need to be conducted to better understand the prevalence of cognitive impairment.
Collapse
Affiliation(s)
- Florence J Dallo
- Department of Public & Environmental Wellness, Oakland University, Rochester, Michigan, US
| | - Tiffany B Kindratt
- Public Health Program, Department of Kinesiology, College of Nursing and Health Innovation, University of Texas at Arlington, US
| | - Laura Zahodne
- Department of Psychology, University of Michigan, Ann Arbor, US
| |
Collapse
|
13
|
Ajrouch KJ, Vega IE, Antonucci TC, Tarraf W, Webster NJ, Zahodne LB. Partnering with Middle Eastern/Arab American and Latino Immigrant Communities to Increase Participation in Alzheimer's Disease Research. Ethn Dis 2020; 30:765-774. [PMID: 33250623 DOI: 10.18865/ed.30.s2.765] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Purpose Recruitment and retention of US ethnic groups traditionally underrepresented in research continues to pose challenges. The Michigan Center for Contextual Factors in Alzheimer's Disease (MCCFAD) engages with two underserved immigrant communities in Michigan - Middle Eastern/Arab Americans in metro-Detroit and Latinos in the Grand Rapids area - to recruit and retain two Participant Resource Pools (PRP). Procedures We adapt an existing community-based participatory research (CBPR) approach to recruit Middle Eastern/Arab American and Latino adults of all ages for Alzheimer's disease and related dementia (ADRD) research. Using American Community Survey (2014-2018) data, we compare socio-demographic characteristics of Middle Eastern/Arab Americans and Latinos living in Michigan to our PRPs. Assessment tools and community advisory board feedback identified missteps and culturally sensitive solutions. Main Findings In the first year of MCCFAD activities, 100 Middle Eastern/Arab Americans and 117 Latinos joined the MCCFAD PRPs. Comparisons to state-level data showed that PRP participants were on average older and more likely to be female than the Middle Eastern/Arab American and Latino populations in Michigan. Further, Middle Eastern/Arab Americans in the PRP reported higher education levels while Latinos reported lower education levels than their respective statewide populations. Community partnerships/feedback identified the importance of connecting with community leaders, attending to matters of within-group diversity, as well as language and semantics. Conclusion Partnership with communities to develop culturally targeted and sensitive community health events can fill a significant gap in addressing ADRD health disparities by establishing sustainable relationships to increase participation in ADRD research.
Collapse
Affiliation(s)
- Kristine J Ajrouch
- Department of Sociology, Anthropology, Criminology, Eastern Michigan University, Ypsilanti, MI
| | - Irving E Vega
- Department of Translational Neuroscience, Michigan State University, Grand Rapids, MI
| | - Toni C Antonucci
- Institute for Social Research, University of Michigan, Ann Arbor, MI
| | - Wassim Tarraf
- Institute of Gerontology and Department of Healthcare Sciences, Wayne State University, Detroit, MI
| | - Noah J Webster
- Institute for Social Research, University of Michigan, Ann Arbor, MI
| | - Laura B Zahodne
- Department of Psychology, University of Michigan, Ann Arbor, MI
| |
Collapse
|
14
|
Chehrehnegar N, Nejati V, Shati M, Rashedi V, Lotfi M, Adelirad F, Foroughan M. Early detection of cognitive disturbances in mild cognitive impairment: a systematic review of observational studies. Psychogeriatrics 2020; 20:212-228. [PMID: 31808989 DOI: 10.1111/psyg.12484] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 09/11/2019] [Accepted: 09/21/2019] [Indexed: 11/28/2022]
Abstract
Mild cognitive impairment (MCI) is an intermediate state between normal cognition and early dementia and is not considered as a typical outcome of brain aging. It has been estimated that 10% to 20% of individuals above 65 years of age will be diagnosed as having MCI. The increased rate of dementia and the importance of early detection of its forerunners have encouraged researchers to focus on detecting MCI and modifiable risk factors with the hope of developing better ways of managing dementia and its consequences. The main aim of this study was to systematically review the related literature concerning the cognitive changes in the spectrum of cognitive aging to cognitive impairment. Articles included in this review were identified through searching the databases of PubMed, Psych Info, Embase, ProQuest, and Scopus. Many domains like verbal memory, language, executive function, visual memory, attentional skills, and working memory showed acceptable predictive power. Testing subdomains such as executive function, speed of processing, working memory and semantic language are critical and others may indicate some suggestions for further clinical deteriorations in normal individuals. Although various cognitive instruments have been used for evaluation of impaired cognitive domains, it remains challenging to select the most appropriate ones having high-level accuracy and their related cognitive subdomains. It also revealed that none of the identified cognitive domains solely fulfilled the criteria for MCI screening; in clinical settings, multiple neuropsychological batteries may be used for one single cognitive domain, while longitudinal studies prefer the use of at least two cognitive measures for each domain to improve accuracy and research settings might focus on only a single neuropsychological test. However, along with episodic memory, testing for amnestic MCI, executive function could increase the chance of early detection of MCI. Executive control has been found to deteriorate the earliest in MCI patients.
Collapse
Affiliation(s)
- Negin Chehrehnegar
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.,Occupational Therapy Department, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Vahid Nejati
- Department of Psychology and Educational Sciences, Shahid Behehsti University Tehran, Tehran, Iran.,Institute for Cognitive and Brain Sciences, Shahid Beheshti University, Tehran, Iran
| | - Mohsen Shati
- Mental Health Research Centre, School of Behavioural Science and Mental health, Tehran Institute of Psychiatry, Iran University of Medical Sciences, Tehran, Iran
| | - Vahid Rashedi
- School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
| | - Mohammadsajad Lotfi
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Fatemeh Adelirad
- Department of Health Education and Promotion, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahshid Foroughan
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| |
Collapse
|
15
|
Girgis I. Protective Factors and Processes Fostering Resilience and Buffering Psychosocial Distress among Later-Life Egyptian Immigrants. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2020; 63:41-77. [PMID: 31948371 DOI: 10.1080/01634372.2020.1715522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 01/08/2020] [Accepted: 01/09/2020] [Indexed: 06/10/2023]
Abstract
This qualitative study explores and describes the protective factors and processes that foster resilience and buffer psychosocial distress among later-life Egyptian immigrants post immigration to the US. Open-ended structured interviews were conducted with (30) later-life Egyptian immigrants who came to the United States after turning 60 years of age. Thematic analysis was used to analyze patterns within the data. The findings of this study reveal that the availability and utilization of psychosocial resources - due to opportunities embedded in their sociocultural context and coping strategies embedded in their individual strengths and cultural or religious beliefs - play a pivotal role in buffering the losses and acculturative stressors triggered by transitioning to a new environment. The findings of this study can be used to inform psychosocial and therapeutic interventions and guide the development of appropriate social work programs and services for later-life Egyptian immigrants in particular and older Arabic-speaking immigrants in general.
Collapse
Affiliation(s)
- Ihab Girgis
- New York State Department of Health, Home Health Care and Hospice, New York, NY, 10007, USA
| |
Collapse
|