scholarly journals Inequity in Health Among People Living With Alzheimer's Disease and Related Dementias in Adult Day Centers

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 330-330
Author(s):  
Gary Yu ◽  
Bei Wu ◽  
Abraham Brody ◽  
Tina Sadarangani ◽  
Jonelle Boafo
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Ethnic Minorities ◽  
English Speakers ◽  
Potential Health ◽  
Adult Day Centers ◽  
Complex Population ◽  
Report Data ◽  
Race Ethnicity ◽  
Racial Ethnic

Abstract In adult day centers (ADCs), 58% of clients identify as racial/ethnic minorities, and at least 30% have Alzheimer’s Disease and related dementias (ADRD). ADCs offer culturally and linguistically congruent care to clients, making them well-positioned to address potential health disparities affecting persons with ADRD. We used data from 53 California ADCs (n=3,053) to identify differences in clinical characteristics among ADC clients’ with ADRD based on demographics such as race and English proficiency. We found that, when compared to their respective counterparts, a significantly greater proportion of racial/ethnic minorities and non-English speakers (p<.001) had 5 or more chronic conditions in addition to ADRD. We noted considerable missing data on race, likely because ADCs in California are not mandated to report data on race/ethnicity. In order to identify inequities in care within this complex population, social determinants of health, including race, must be a standard component of client assessment.

scholarly journals Synergistic Action of Flavonoids, Baicalein, and Daidzein in Estrogenic and Neuroprotective Effects: A Development of Potential Health Products and Therapeutic Drugs against Alzheimer’s Disease

2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
Roy C. Y. Choi ◽  
Judy T. T. Zhu ◽  
Amanda W. Y. Yung ◽  
Pinky S. C. Lee ◽  
Sherry L. Xu ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Transcriptional Activation ◽  
Estrogenic Activity ◽  
Neuroprotective Effects ◽  
Potential Health ◽  
Amyloid A ◽  
Therapeutic Drugs ◽  
Health Products

Despite the classical hormonal effect, estrogen has been reported to mediate neuroprotection in the brain, which leads to the searching of estrogen-like substances for treating neurodegenerative diseases. Flavonoids, a group of natural compounds, are well known to possess estrogenic effects and used to substitute estrogen, that is, phytoestrogen. Flavonoid serves as one of the potential targets for the development of natural supplements and therapeutic drugs against different diseases. The neuroprotection activity of flavonoids was chosen for a possible development of anti-Alzheimer's drugs or food supplements. The estrogenic activity of two flavonoids, baicalein and daidzein, were demonstrated by their strong abilities in stimulating estrogen receptor phosphorylation and transcriptional activation of estrogen responsive element in MCF-7 breast cells. The neuroprotection effects of flavonoids againstβ-amyloid (Aβ) were revealed by their inhibition effects onin vitroAβaggregation and Aβ-induced cytotoxicity in PC12 neuronal cells. More importantly, the estrogenic and neuroprotective activities of individual flavonoid could be further enhanced by the cotreatment in the cultures. Taken together, this synergistic effect of baicalein and daidzein might serve as a method to improve the therapeutic efficacy of different flavonoids against Aβ, which might be crucial in developing those flavonoidsin treating Alzheimer's disease in the future.

A Systematic Review of Parenting Scales Measurement Invariance/Equivalence of by Race and Ethnicity: Recommendations for Inclusive Parenting Research

Assessment ◽  
2021 ◽  
pp. 107319112110386
Author(s):  
Violeta J. Rodriguez ◽  
Dominique L. La Barrie ◽  
Miriam C. Zegarac ◽  
Anne Shaffer
Keyword(s):  
Systematic Review ◽  
Measurement Invariance ◽  
Ethnic Minorities ◽  
Race And Ethnicity ◽  
Parenting Practices ◽  
The United States ◽  
Weak Evidence ◽  
Race Ethnicity ◽  
Development And Validation ◽  
Racial Ethnic

The limited inclusion of racial/ethnic minorities in the development and validation of parenting measures limits our understanding of whether parenting constructs are valid in racial and ethnic minorities. Tests of measurement invariance/equivalence (MI/E) of parenting measures can help evaluate the validity of parenting constructs among racial/ethnic minorities. This systematic review summarized studies on MI/E of parenting constructs by race/ethnicity and evaluated the strength of the evidence. A literature search was conducted using various databases and references to retrieve studies from the United States. Indeed, 10 studies were identified that tested for MI/E of eight parenting scales by race/ethnicity. Only one scale showed moderate evidence of MI/E, five showed weak evidence of MI/E, and two showed no evidence of MI/E. Most studies (80%) used factor analytic methods to test for MI/E, but only two studies (20%) examined all levels of invariance. These findings show that differences exist in how racial/ethnic minorities perceive parenting constructs. Further research is needed to develop more inclusive parenting measures, to protect against the ways in which biased measures may pathologize or misrepresent parenting practices among racial/ethnic minorities.

scholarly journals Mediterranean and MIND Diets Containing Olive Biophenols Reduces the Prevalence of Alzheimer’s Disease

2019 ◽  
Vol 20 (11) ◽  
pp. 2797 ◽  
Author(s):  
Syed Haris Omar
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Decline ◽  
Neurological Disorders ◽  
Bioactive Constituents ◽  
Potential Health ◽  
Future Directions ◽  
The Past ◽  
Ketogenic Diets ◽  
Mind Diet

The risk of Alzheimer’s disease (AD) increases with nonmodifiable conditions including age and lack of effective efficacious pharmacotherapy. During the past decades, the non-pharmacotherapy mode of treatment of dietary modification received extensive attention in AD research. In order to reduce the AD pathology and cognitive decline, various dietary patterns have been attempted including caloric restriction (CR), dietary approaches to stop hypertension (DASH), ketogenic diets (KD), Mediterranean diet (MedDi) and Mediterranean-DASH diet Intervention for Neurological Delay (MIND) diet. Higher adherence to the MedDi diet was associated with decreases in cardiovascular and neurological disorders including AD and related cognitive decline. However, another emerging healthy dietary pattern MIND diet has also been associated with slower rates of cognitive decline and significant reduction of AD rate. Olive serves as one of the building block components of MedDi and MIND diets and the exerted potential health beneficial might be suggested due to the presence of its bioactive constituents such as oleic acids and phenolic compounds (biophenols). A few trials using medical food showed an optimal result in presymptomatic or early stages of AD. The review supports the notion that MedDi and MIND diets display potential for maintaining the cognitive function as nonpharmacological agents against AD pathology and proposed preventative mechanism through the presence of olive biophenols and presents the gaps along with the future directions.

A Review of the Validity of Juvenile Risk Assessment Across Race/Ethnicity

2018 ◽  
Author(s):  
Christina Campbell ◽  
William Miller
Keyword(s):  
Risk Assessment ◽  
Decision Making ◽  
Ethnic Minorities ◽  
Minority Groups ◽  
Critical Role ◽  
The United States ◽  
Risk Assessments ◽  
Assessment Instruments ◽  
Race Ethnicity ◽  
Racial Ethnic

Juvenile risk assessment instruments have provided juvenile courts with the opportunity to make standardized decisions concerning sentences and intervention needs. Risk assessments have replaced the reliance on professional decision-making practices in which court officials relied on their hunches or previous experience to determine what to do with youth once they became involved in corrections. A primary goal of juvenile risk assessment is to improve case management and help courts focus resources on juveniles who exhibit the greatest intervention needs. Further, juvenile risk assessments play a critical role in estimating which juveniles will likely reoffend by identifying factors that increase the propensity of future offending. Although some researchers believe that the implementation of standardized juvenile risk assessments is a good strategy for reducing biased decision-making for racial/ethnic minorities, other researchers have called into question the extent to which risk assessments overestimate risk for certain juveniles, especially those in minority groups who have a history of being marginalized due to their race, culture, or ethnicity. This article provides an overview of how well juvenile risk assessment instruments predict future delinquency across race and ethnicity. The review suggests that in general, risk assessments do a good job in predicting recidivism across racial/ethnic groups for diverse populations inside and outside the United States. However, there is still some room for improvement concerning the assessment of risk and needs for ethnic minorities. In addition, while there are some studies that do not report the predictive validity of risk assessment scores across race/ethnicity, risk assessments overall seem to be a promising effort to correctly classify and/or identify juveniles who are at greatest risk for future recidivism.

scholarly journals Advancing Alzheimer’s Disease Care and Services Among Racial and Ethnic Minorities

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 745-745
Author(s):  
Lenora Smith ◽  
Roland Thorpe
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
African American ◽  
Ethnic Minorities ◽  
Health Care Expenditures ◽  
Racial And Ethnic Minorities ◽  
Care Services ◽  
Study Results ◽  
Using Data ◽  
The Impact

Abstract Research shows consistent and adverse disparities among racial and ethnic minorities compared to non-Hispanic Whites in the prevalence and incidence of Alzheimer’s disease, mortality, participation in clinical trials, use of medications and other interventions, health care expenditures, and quality-of-life outcomes. The literature suggests numerous underlying causes, including factors related to measurement of the disease, genetics, socioeconomic factors, cultural differences, lack of culturally competent interventions, and discrimination in services and care. Although these disparities are well known, little is known about the effectiveness of various strategies to address these differences within the context of Alzheimer’s disease services and care. This symposium aims to contribute to this knowledge. The first presentation examines the role of race with marital status and risk for dementia using data from the Health and Retirement Study. Results suggest differences for unmarried White and unmarried older adults of color, which can inform dementia care services. The second presentation highlights the opportunities and challenges of facilitating cognitive impairment screenings among African American congregations. The third presentation introduces attitudes about brain donation among African American research participants and suggestions to increase involvement. The symposium concludes with a presentation on hearing care disparities in dementia with practical recommendations on how to close this gap in hearing care. The findings from these papers contribute significantly to the impact of ethnoracial differences in dementia and the need to include more diverse populations in ADRD research to promote equity. Alzheimer’s Disease Research Interest Group Sponsored Symposium.

Trastuzumab-induced cardiotoxicity and hypertension among racially and ethnically diverse patients with HER2-positive early-stage breast cancer.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e24092-e24092
Author(s):  
Monica F. Chen ◽  
Daniel K. Manson ◽  
Ariel Yuan ◽  
Katherine D. Crew
Keyword(s):  
Breast Cancer ◽  
Ethnic Groups ◽  
Ethnic Minorities ◽  
Early Stage ◽  
Early Stage Breast Cancer ◽  
Her2 Positive ◽  
Factors Associated ◽  
Race Ethnicity ◽  
Racial Ethnic ◽  
Hispanic White

e24092 Background: Trastuzumab improves breast cancer survival but is associated with an increased risk of heart failure. Identifying risk factors associated with trastuzumab induced cardiotoxicity (TIC) would allow for more targeted and intensive screening for at-risk patients. Hypertension is one of the most consistent predictors of TIC. Racial/ethnic minorities are at higher risk of cardiovascular disease but are under-represented in studies of TIC. The objective of this study was to evaluate the relationship between race/ethnicity and risk of TIC among a diverse cohort of patients with HER2-positive early-stage breast cancer. Methods: We conducted a retrospective cohort study of patients treated at Columbia University between 2007 and 2016 for stage I-III breast cancer with adjuvant or neoadjuvant trastuzumab who had at least two echocardiograms. Mild TIC was defined as a ≥10% decline in left ventricular ejection fraction (LVEF); moderate TIC ≥15% decline; severe TIC ≥20% or decline in LVEF to < 50%. Diagnosis of hypertension, average systolic and diastolic blood pressure, and number of hypertension medications was assessed 1- year pre-treatment, during treatment, and 1-year post-treatment. We generated descriptive statistics and used multivariable logistic regression to evaluate demographic and clinical factors associated with TIC. Results: Of 279 patients evaluated, 36.6% were non-Hispanic white, 18.3% non-Hispanic black, 34.8% Hispanic, and 10.4% Asian. The average baseline LVEF was 60% and did not significantly differ between racial/ethnic groups. Mild TIC developed in 33.3% of patients, moderate TIC 18.6%, severe TIC 15.8%, and 14.7% with LVEF decline to < 50%. Patients with hypertension were at increased odds of developing TIC (OR = 2.41, 95% CI = 1.15-3.93; p = 0.02). Prevalence of hypertension was 53% among non-Hispanic white women, 69% non-Hispanic black, 53% Hispanic, and 39% Asian. Incidence of TIC did not differ significantly between racial/ethnic groups. Forty percent of patients with hypertension were not on any medications before initiating trastuzumab. Conclusions: There was no difference in TIC based upon race/ethnicity despite higher rates of hypertension among racial/ethnic minorities compared to non-Hispanic whites. However, a high portion of patients with hypertension were not on any medications before treatment. Increased screening and treatment of hypertension among patients receiving HER2-positive targeted therapy for early-stage breast cancer may be warranted.

scholarly journals Dementia Care in Diverse Older Adults in the U.S. Deep South and the Rest of the United States

2021 ◽  
pp. 1-13
Author(s):  
Maria Pisu ◽  
Roy C. Martin ◽  
Liang Shan ◽  
Giovanna Pilonieta ◽  
Richard E. Kennedy ◽  
...  
Keyword(s):  
United States ◽  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Drug Use ◽  
Ethnic Groups ◽  
The United States ◽  
Deep South ◽  
Racial Ethnic ◽  
The U.S

Background: Use of specialists and recommended drugs has beneficial effects for older adults living with Alzheimer’s disease and related dementia (ADRD). Gaps in care may exist for minorities, e.g., Blacks, and especially in the United States (U.S.) Deep South (DS), a poor U.S. region with rising ADRD cases and minority overrepresentation. Currently, we have little understanding of ADRD care utilization in diverse populations in this region and elsewhere in the U.S. (non-DS), and the factors that adversely impact it. Objective: To examine utilization of specialists and ADRD drugs (outcomes) in racial/ethnic groups of older adults with ADRD and the personal or context-level factors affecting these outcomes in DS and non-DS. Methods: We obtained outcomes and personal-level covariates from claims for 127,512 Medicare beneficiaries with ADRD in 2013–2015, and combined county-level data in exploratory factor analysis to define context-level covariates. Adjusted analyses tested significant association of outcomes with Black/White race and other factors in DS and non-DS. Results: Across racial/ethnic groups, 33%–43% in DS and 43%–50% in non-DS used specialists; 47%–55% in DS and 41%–48% in non-DS used ADRD drugs. In adjusted analyses, differences between Blacks and Whites were not significant. Vascular dementia, comorbidities, poverty, and context-level factor “Availability of Medical Resources” were associated with specialist use; Alzheimer’s disease and senile dementia, comorbidities, and specialist use were associated with drug use. In non-DS only, other individual, context-level covariates were associated with the outcomes. Conclusion: We did not observe significant gaps in ADRD care in DS and non-DS; however, research should further examine determinants of low specialist and drug use in these regions.

scholarly journals Multiple sleep dimensions and type 2 diabetes risk among women in the Sister Study: differences by race/ethnicity

2019 ◽  
Vol 7 (1) ◽  
pp. e000652 ◽  
Author(s):  
Ketrell L McWhorter ◽  
Yong-Moon Park ◽  
Symielle A Gaston ◽  
Kacey B Fang ◽  
Dale P Sandler ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Ethnic Minorities ◽  
Sleep Latency ◽  
Diabetes Risk ◽  
Poor Sleep ◽  
Increased Risk ◽  
Race Ethnicity ◽  
Racial Ethnic

ObjectivePoor sleep has been associated with type 2 diabetes. Since racial/ethnic minorities experience a disproportionately high prevalence of poor sleep and type 2 diabetes, we sought to determine the relationships between multiple sleep dimensions and incident type 2 diabetes and to investigate if these relationships vary by race/ethnicity.Research design and methodsProspective data were analyzed from the Sister Study, which enrolled 50 884 women from 2003 to 2009. Participants self-reported sleep duration, sleep latency, night awakenings, and napping at baseline, and a physician’s diagnosis of type 2 diabetes at follow-up. Multivariable-adjusted HRs and 95% CIs were estimated using Cox proportional hazards models.ResultsAmong the 39 071 eligible participants, 87% self-identified as white, 8% black and 5% Hispanic/Latina. The mean follow-up period was 8.5±2.1 years and 1785 type 2 diabetes cases were reported. The incidence rate per 1000 person-years was 5.4 for whites, 13.3 for blacks and 11.6 for Hispanics/Latinas. There was a positive but non-significant increased risk of type 2 diabetes among women who reported short sleep, latency >30 min and frequent night awakenings. In fully-adjusted models, frequent napping was associated with a 19% (HR 1.19, 95% CI 1.04 to 1.37) higher type 2 diabetes risk in the overall sample. Poor sleep among racial/ethnic minorities ranged from a 1.4-fold to a 3.2-fold higher type 2 diabetes risk than whites with recommended sleep.ConclusionsFrequent napping was associated with higher type 2 diabetes risk. Racial/ethnic minorities with poor sleep had a higher type 2 diabetes risk than whites with recommended sleep.

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