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Advisory Council October 2016 Meeting Presentation: Racial/Ethnic Statistics and Demographics

ADVISORY COUNCIL ON ALZHEIMER'S RESEARCH, CARE, AND SERVICES

Monday, October 31, 2016

Printer Friendly Version in PDF Format (7 PDF pages)

 

Prevalence and Incidence of Dementia in Race/Ethnic Populations in the U.S.

Gwen Yeo, PhD, AGSF

Systematic Review of Prevalence and Incidence of Dementia in US Race/Ethnic Populations

Mehta and Yeo

  • Search
    • 1229 studies reviewed
  • Data Base
    • 114 with appropriate recruitment and diagnostic methods included in data base
  • Analysis
    • Comparisons very difficult
    • Different ages, methodologies, reporting styles

What Do We Know About Dementia Prevalence in Race/Ethnic Populations?

African Americans

  • (10 of the 19 studies)
    • ~ ages of samples from 40+ to 100+
    • ~ prevalence ranges from 0.01% to 68%
    • ~ four reported age >65: 7%, 8%, 16%, 22%
    • ~ four reported age > 85: 18%, 23%, 32%, 59%

In the 8 studies who also had a non-Latino white comparison group, all but one showed lower rates for whites.

Latino/Hispanic Prevalence

  • Mexican American
    • SALSA > 60: 5%; >85: 31%
  • Puerto Rican (PR)
    • PR Veterans > 65: 13%
  • Cuban American (women)
    • > 65: 13%
  • Caribbean Hispanic (Dominican, PR, & Cuban)
    • 65-74: 8%
    • 75-84: 28%
    • > 85: 63% in those aged 85 and over.

Asian American Prevalence

  • Japanese Americans
    • Honolulu Heart Study/HAAS Men
      • > 65: 8%; >85: 33%
    • Kame Study (Seattle area)
      • > 65: 6%
    • Korean American MASK-MD
    • (screening data only) > 60: 7%

NO DATA AVAILABLE ON OTHER ASIAN AMERICAN POPULATIONS

American Indian Prevalence

NO RELIABLE REPORTS AMONG AMERICAN INDIAN POPULATIONS

Pacific Islander Prevalence

  • Chamorros (indigenous population of Guam)
    • > 65: 12% (9% Guam Dementia)

AVERAGE ANNUAL INCIDENCE BY RACE/ETHNICITY

Line chart.

What Did We Learn?

  • There are major gaps in the evidence for rates of prevalence or incidence among different race/ethnic populations.
    • American Indians
    • Most Asian American populations
      • Chinese, Filipino, Asian Indian, Vietnamese
      • Smaller Asian groups
    • Most Pacific Islander populations
  • It is impossible to compare results of studies fairly within or across population groups because of differences in:
    • Age of subjects
    • Recruitment and inclusion strategies
    • Diagnostic methods
    • How results are reported
      • By age categories only?
      • By gender categories only?

Result: Disparities cannot accurately be documented

  • It is important to disaggregate data on ethnic populations within the large race/ethnic categories used by OMB.
    • For example, the lowest and highest rates are found among populations classified as Hispanic/Latino. If lumped together, the results are misleading.

Northern CA Kaiser Permanente Multi-Ethnic Incidence Study, 2016

Followed 274 thousand patients >60 for 14 years, age adjusted dementia incidence rates per 1000 person/years were:

Asian American 15.2
NL White 19.4
Pacific Islander 19.6
Latino 19.6
American Indian/AN 22.2
African American 26.6
Mayeda et al.

Recommendations to Increase our Knowledge about Disparities

  • Develop standardized protocol for race/ethnic epidemiological research
  • Prioritize funding for ethnic specific populations with little or no data
  • Require inclusion of target community members in research team

Next Steps

  • Knowledge of Risk Factors
  • Interventions
  • Decrease in Disparities

Return to

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