@article {11222, title = {Changes in physical and mental health of Black, Hispanic, and White caregivers and non-caregivers associated with onset of spousal dementia.}, journal = {Alzheimer{\textquoteright}s \& Dementia}, volume = {6}, year = {2020}, pages = {e12082}, abstract = {

Introduction: We aim to determine whether racial/ethnic health disparities are a consequence of caregiving for persons with dementia and/or health status before becoming a caregiver.

Methods: Longitudinal data from the Health and Retirement Study (1998-2012) on 7859 Black, Hispanic, and White couples were analyzed for changes in physical and mental health with incident dementia of a spouse.

Results: Blacks and Hispanics, but not Whites, had poorer health before becoming caregivers for a spouse with dementia, than those who did not become caregivers. Spouse{\textquoteright}s dementia onset was associated with caregiver{\textquoteright}s higher odds of depressive disorder, with no racial/ethnic variation. Racial disparities in caregiver{\textquoteright}s health were attributed to health differences before caregiving, not differential health changes due to caregiving.

Discussion: Older Blacks and Hispanics with poor health are at increased risk of caregiving for a spouse with dementia. Protecting the health of persons supporting spouses with dementia requires understanding socioeconomic and cultural factors driving care provision.

}, keywords = {Caregiving, Dementia, depression, Racial Disparities}, issn = {2352-8737}, doi = {10.1002/trc2.12082}, author = {Chen, Cynthia and Thunell, Johanna and Julie M Zissimopoulos} } @article {10150, title = {Analysis of dementia in the US population using Medicare claims: Insights from linked survey and administrative claims data.}, journal = {Alzheimers Dement (N Y)}, volume = {5}, year = {2019}, month = {2019}, pages = {197-207}, abstract = {

Introduction: Medicare claims data may be a rich data source for tracking population dementia rates. Insufficient understanding of completeness of diagnosis, and for whom, limits their use.

Methods: We analyzed agreement in prevalent and incident dementia based on cognitive assessment from the Health and Retirement Study for persons with linked Medicare claims from 2000 to 2008 (N~=~10,450 persons). Multinomial logistic regression identified sociodemographic factors associated with disagreement.

Results: Survey-based cognitive tests and claims-based dementia diagnosis yielded equal prevalence estimates, yet only half were identified by both measures. Race and education were associated with disagreement. Eighty-five percent of respondents with incident dementia measured by cognitive decline received a diagnosis or died within the study period, with lower odds among blacks and Hispanics than among whites.

Discussions: Claims data are valuable for tracking dementia in the US population and improve over time. Delayed diagnosis may underestimate rates within black and Hispanic populations.

}, keywords = {Cognitive Ability, Dementia, Education, Medicare claims, Medicare linkage, Racial/ethnic differences}, issn = {2352-8737}, doi = {10.1016/j.trci.2019.04.003}, author = {Chen, Yi and Tysinger, Bryan and Eileen M. Crimmins and Julie M Zissimopoulos} } @article {9727, title = {The Impact of Changes in Population Health and Mortality on Future Prevalence of Alzheimer{\textquoteright}s Disease and Other Dementias in the United States}, journal = {The Journals of Gerontology: Series B}, volume = {73}, year = {2018}, pages = {S38-S47}, abstract = {Objectives We assessed potential benefits for older Americans of reducing risk factors associated with dementia. Methods A dynamic simulation model tracked a national cohort of persons 51 and 52 years of age to project dementia onset and mortality in risk reduction scenarios for diabetes, hypertension, and dementia. Results We found reducing incidence of diabetes by 50\% did not reduce number of years a person ages 51 or 52 lived with dementia and increased the population ages 65 and older in 2040 with dementia by about 115,000. Eliminating hypertension at middle and older ages increased life expectancy conditional on survival to age 65 by almost 1 year, however, it increased years living with dementia. Innovation in treatments that delay onset of dementia by 2 years increased longevity, reduced years with dementia, and decreased the population ages 65 and older in 2040 with dementia by 2.2 million. Conclusions Prevention of chronic disease may generate health and longevity benefits but does not reduce burden of dementia. A focus on treatments that provide even short delays in onset of dementia can have immediate impacts on longevity and quality of life and reduce the number of Americans with dementia over the next decades.}, keywords = {Alzheimer{\textquoteright}s disease, Dementia, Mortality, Population Health}, issn = {1079-5014}, doi = {10.1093/geronb/gbx147}, url = {https://academic.oup.com/psychsocgerontology/article/73/suppl_1/S38/4971567http://academic.oup.com/psychsocgerontology/article-pdf/73/suppl_1/S38/24626796/gbx147.pdf}, author = {Julie M Zissimopoulos and Tysinger, Bryan and Patricia A St Clair and Eileen M. Crimmins} } @article {9947, title = {Racial and ethnic differences in trends in dementia prevalence and risk factors in the United States.}, journal = {Alzheimer{\textquoteright}s \& Dementia (N Y)}, volume = {4}, year = {2018}, pages = {510-520}, abstract = {

Introduction: Disparities in dementia prevalence across racial/ethnic groups in the United States may not be narrowing over time.

Methods: Data from Health and Retirement Study (2000 to 2012) were analyzed. Dementia was ascertained based on cognitive, functional measures. Logistic regression was used to quantify association between dementia and risk factors, including chronic conditions, use of drug treatment for them, separately for whites, blacks, and Hispanics.

Results: Disparities in dementia prevalence declined between blacks and whites and increased between Hispanics and whites. Adjusting for risk factors reduced but did not eliminate disparities. Compared to no hypertension, untreated hypertension was associated with increased risk of dementia for all racial/ethnic groups while treated hypertension was associated with reduced risk for whites. Diabetes treated with oral drugs was not associated with increased dementia risk.

Discussion: Racial disparities in dementia may be reduced by prevention and management of disease and promoting educational attainment among blacks and Hispanics.

}, keywords = {Cognition \& Reasoning, Dementia, Racial/ethnic differences, Risk Factors}, issn = {2352-8737}, doi = {10.1016/j.trci.2018.08.009}, author = {Chen, Cynthia and Julie M Zissimopoulos} }