可能性和疑似痴呆的患病率、危险因素及种族差异：国家健康与老龄化趋势研究
Prevalence, risk factors, and racial disparities in probable and possible dementia: the national health and aging trends study.
文献信息
| PMID | 42731172 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Young-Shin Lee |
| 作者单位 | School of Nursing, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182, United States. Electronic address: ylee@sdsu.edu. |
| 期刊 | The journal of prevention of Alzheimer's disease |
| SCI 分区 | Q1 |
| IF | 8.4 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
背景： 尽管全球框架强调了认知衰退的可改变危险因素，但关于这些风险如何影响不同人群的证据仍然有限。本研究在一个全国代表性样本中确定可能性和疑似痴呆的患病率，识别主要预测因素，并调查不同种族和族裔群体之间的风险差异。
方法： 使用2023年国家健康与老龄化趋势研究（NHATS）中7,574名老年人的样本，将认知状态分类为可能性痴呆、疑似痴呆或无痴呆。采用带交互项的调查加权多项逻辑回归模型，检验年龄、健康状况和感官矫正在不同人口统计学特征下的条件效应。
结果： 高龄、低教育程度、卒中、跌倒和抑郁/焦虑与可能性和疑似痴呆（Prb-D）的更高比值比相关，而女性、视力和助听器使用降低了Prb-D的比值比。85岁及以上的西班牙裔成年人面临60.2%的Prb-D预测概率，而非西班牙裔（NH）白人成年人为35.1%。低教育程度不成比例地增加了Prb-D患病率，尤其是在西班牙裔中。在助听器使用者中，NH白人和NH黑人成年人比非使用者显示出更低的Prb-D概率，而西班牙裔使用者显示出更高的概率。咀嚼或吞咽问题使西班牙裔成年人的Prb-D概率严重升高（42.2%），而NH白人为19.3%，抑郁使Prb-D的总体风险加倍。
结论： 认知衰退的负担极不平等，证明标准化干预对少数族裔老年人不足。解决这些差异需要文化上响应性的照护路径，并消除结构性障碍，特别是听力学和牙科服务保险覆盖不足的问题。
英文摘要
BACKGROUND: While global frameworks highlight modifiable risk factors for cognitive decline, evidence on how these risks affect diverse populations remains limited. This study determines the prevalence of probable and possible dementia, identifies primary predictors, and investigates risk variations across racial and ethnic groups in a nationally representative sample.
METHODS: Using a sample of 7,574 older adults from the 2023 National Health and Aging Trends Study (NHATS), cognitive status was classified as probable, possible, or no dementia. Survey-weighted multinomial logistic regression models with interaction terms examined conditional effects of age, health conditions, and sensory corrections across demographics.
RESULTS: Advanced age, low education, stroke, falls, and depression/anxiety were associated with higher Odds of possible and probable dementia (Prb-D), while female, vision and hearing aid use lowered Prb-D odds. Hispanic adults aged 85 and older faced a 60.2% predicted probability of Prb-D, compared to 35.1% for Non-Hispanic (NH) White adults. Low education disproportionately increased Prb-D prevalence, especially among Hispanics. Among hearing aid users, NH White and NH Black adults showed lower of Prb-D probability than non-users, whereas Hispanic users showed a higher probability. Chewing or swallowing problems severely escalated Prb-D probability for Hispanic adults (42.2%) compared to NH Whites (19.3%), and depression doubled the overall risk of Prb-D.
CONCLUSION: The burden of cognitive decline is deeply unequal, proving standardized interventions insufficient for minority older adults. Addressing these disparities necessitates culturally responsive care pathways and the elimination of structural barriers, particularly inadequate insurance coverage for audiology and dental services.