TY - JOUR T1 - Risk perception and preference for prevention of Alzheimer's disease. JF - Value Health Y1 - 2009 A1 - Chung, Sukyung A1 - Kala M. Mehta A1 - Shumway, Martha A1 - Alvidrez, Jennifer A1 - Eliseo J Perez-Stable KW - Age Factors KW - Aged KW - Aged, 80 and over KW - Alzheimer disease KW - Cognition KW - Female KW - Health education KW - Health Knowledge, Attitudes, Practice KW - Health Surveys KW - Humans KW - Linear Models KW - Male KW - Multivariate Analysis KW - Psychometrics KW - Risk Assessment KW - Risk Factors KW - Social Perception KW - Statistics as Topic KW - United States AB -
OBJECTIVES: To understand how older adults perceive their risk of Alzheimer's Disease (AD) and how this may shape their medical care decisions, we examined whether presence of established risk factors of AD is associated with individuals' perceived risk of AD, and with preference for preventing AD.
PARTICIPANTS: Data came from the US Health and Retirement Study participants who were asked questions on AD risk perception (N = 778).
MEASUREMENTS: Perceived risk of AD was measured by respondents' estimate of their percent chance (0-100) developing AD in the next 10 years. Preference for AD prevention was measured with questions eliciting willingness to pay for a drug to prevent AD.
ANALYSIS: Multivariate linear regressions were used to estimate correlates of perceived risk and preference for prevention.
RESULTS: Better cognitive functioning and physical activity are associated with decreased perceived risk. Neither age nor cardiovascular disease is associated with perceived risk. African Americans have lower perceived risk than non-Latino whites; the difference is wider among people age 65 and above. Only 4% to 7% of the variation in perceived risk was explained by the model. Preference for prevention is stronger with increased perceived risk, but not with the presence of risk factors. Persons with better cognitive functioning, physical functioning, or wealth status have a stronger preference for prevention.
CONCLUSION: Some known risk factors appear to inform, but only modestly, individuals' perceived risk of AD. Furthermore, decisions about AD prevention may not be determined by objective needs alone, suggesting a potential discrepancy between need and demand for AD preventive care.
PB - 12 VL - 12 IS - 4 U1 - http://www.ncbi.nlm.nih.gov/pubmed/19900252?dopt=Abstract U3 - 19900252 U4 - Alzheimers Disease/risk factors/Subjective Probabilities/Physical Activity/Cognitive Functioning ER - TY - JOUR T1 - Race/ethnic differences in cognitive decline: Results from the health and retirement study JF - Alzheimer's and dementia : the journal of the Alzheimer's Association Y1 - 2008 A1 - Kala M. Mehta A1 - Lisa L. Barnes A1 - Roland J. Thorpe Jr. A1 - Eliseo J Perez-Stable A1 - Kenneth E Covinsky A1 - Kristine Yaffe KW - Health Conditions and Status AB - Background: As the minority population and dementia prevalence are rapidly growing, understanding cognitive decline in racially diverse elders is an increasingly important public health issue. Our goal was to evaluate whether cognitive decline occur at an accelerated rate for persons of non-White race/ethnicity (African American, Latino) compared to White older adults. Methods: Participants were from the US-representative Health and Retirement Study (HRS) 1998-2004. Cognitive assessment consisted of immediate and delayed free recall as well as serial 7s test, orientation, and naming for a total score of 35 points. Our primary outcomes were biennial cognitive change from 1998 to 2004 and cognitive decline defined as 5 point decline from 1998 to 2004. We calculated change in cognition, odds of cognitive decline, and evaluated mediators by race/ethnic group using mixed effects regression and logistic regression models. Results: The 5,552 HRS participants (mean age 72 6 years, 60 Female, 10 African Amercan, 6 Latino) had an average cognitive decline of 2.1 4.3 points over the 6 year study period. Overall, 33 of African Americans declined, 28 of Latinos declined and 26 of Whites declined. After controlling for age, gender, educational level in years, socioeconomic factors (total net worth and current income), self-reported medical comorbidity (self reported medical history of hypertension, heart disease, diabetes and stroke), and baseline cognition, African Americans were more likely to decline compared to Whites (OR 2.2; 95 CI 1.7-2.7). Latino older adults were similar to Whites in odds of cognitive decline (OR Latino 1.3; 95 CI 0.9-1.7). Conclusions: African American adults aged 65 and above were more likely to experience cognitive decline compared to White older adults after accounting for demographics, socioeconomics, comorbidity, and their baseline cognitive function. There was no difference between Latino older adults and Whites in rates of cognitive decline. Future research to identify ways to reduce cognitive decline, particularly for racially-diverse groups, are needed. PB - 4 VL - 4 IS - 4 U4 - Dementia/Cognitive decline/COMORBIDITY ER -