scholarly journals Racial Differences in the Effect of Alzheimer’s Disease on Adherence to Medication Therapy for Chronic Diseases

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 60-61
Author(s):  
Arseniy Yashkin ◽  
Anatoliy Yashin ◽  
Galina Gorbunova ◽  
Igor Akushevich
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Chronic Diseases ◽  
Racial Differences ◽  
Chronic Conditions ◽  
Single Individual ◽  
Medication Therapy ◽  
Adherence To Medication ◽  
Race Ethnicity ◽  
Reduced Adherence

Abstract Multiple dementia (the presence of one or more types of dementia in a single individual) and multi-morbidity (the presence of multiple chronic diseases in an individual) present a major challenge to the U.S. healthcare system. The reduction in cognitive function associated with neurocognitive disorders such as Alzheimer’s Disease (AD) and Related Dementias (ADRD) reduce the ability of the affected individual to take care of him/herself. This can manifest as reduced adherence to medication regimens designed to manage other chronic conditions, in reduced ability to engage in healthy behavior such as exercise, or in other ways. The result is an increase in the probability of otherwise avoidable adverse health outcomes and related healthcare costs. In this study, we showcase two high impact chronic conditions common in the elderly: hypertension and type 2 diabetes mellitus (T2D). Using a 5% sample of the total Medicare population we identify groups of individuals with AD/ADRD and i) hypertension, ii) T2D or iii) both. Each group is then propensity-score-matched to similar individuals with hypertension, T2D or both but without a diagnosis of AD/ADRD. The primary explanatory variable of interest is the medication possession ratio (MPR) calculated at 1-year intervals for prescribed diabetes and/or hypertension medications. MPRs were compared between the two groups using t-tests and standardized differences each year after baseline and until death/censoring. A Cox proportional hazard model was then used to estimate differences in survival between these two groups and across race/ethnicity-related strata. Reduced adherence with time and notable race/ethnicity-related differences were identified.

Decoding Causal Links Between Sleep Apnea and Alzheimer’s Disease

2021 ◽  
pp. 1-12
Author(s):  
Luigi Ferini-Strambi ◽  
Michael Hensley ◽  
Maria Salsone
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Chronic Diseases ◽  
Chronic Conditions ◽  
Brain Regions ◽  
New Model ◽  
Obstructive Sleep ◽  
The Brain

Obstructive sleep apnea (OSA) and Alzheimer’s disease (AD) are two common chronic diseases with a well-documented association. Whether the association is causal has been highlighted by recent evidence reporting a neurobiological link between these disorders. This narrative review discusses the brain regions and networks involved in OSA as potential vulnerable areas for the development of AD neuropathology with a particular focus on gender-related implications. Using a neuroimaging perspective supported by neuropathological investigations, we provide a new model of neurodegeneration common to OSA and AD, that we have called OSA-AD neurodegeneration in order to decode the causal links between these two chronic conditions.

scholarly journals Promoting Conversations About Cognitive Decline Between Older Adults and Primary Care Providers

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 157-158
Author(s):  
Benjamin Olivari ◽  
Christopher Taylor ◽  
Nia Reed ◽  
Lisa McGuire
Keyword(s):  
Alzheimer’S Disease ◽  
Primary Care ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Chronic Conditions ◽  
Memory Loss ◽  
Primary Care Providers ◽  
Subjective Cognitive Decline ◽  
Care Providers

Abstract Alzheimer’s disease and related dementias often begin with symptoms of mild memory loss, eventually leading to more severe cognitive impairment, functional impairment, and ultimately, death. Data from the Behavioral Risk Factor Surveillance System core questions related to chronic diseases and from the cognitive decline optional module on subjective cognitive decline (SCD) from the years 2015-2018 were aggregated across the participating 50 states, D.C., and Puerto Rico for this analysis. Among U.S. adults aged 65 years and older, only 39.8% (95%CI=37.6-42.1) of those experiencing SCD reported discussing their SCD symptoms with a healthcare provider. The prevalence of discussing SCD symptoms with a provider was higher among those with at least one chronic condition than among those with no chronic conditions. 30.7% (28.6-32.8) of those aged 65 years and older reported that their SCD led to functional limitations and 28.8% (26.5-31.2) needed assistance with day-to-day activities. For patients aged 65 years and older, Welcome to Medicare visits and Medicare Annual Wellness Visits are critically underutilized primary care access points. Primary care providers can manage chronic conditions, cognitive health, and initiate referrals for testing. Efforts to promote the use of toolkits and diagnostic codes that are available to primary care providers to initiate conversations about memory loss with patients may be utilized to improve detection, diagnosis, and planning for memory problems. Discussions may lead to earlier detection and diagnosis of cognitive impairment, such as Alzheimer’s disease, or other treatable conditions such as delirium or pressure in the brain and avoid costly hospitalizations.

scholarly journals Drug treatment for early Alzheimer's disease

1998 ◽  
Vol 4 (3) ◽  
pp. 126-134 ◽  
Author(s):  
Roger Bullock
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Molecular Biology ◽  
Drug Treatment ◽  
21St Century ◽  
Chronic Conditions ◽  
Epidemiological Studies ◽  
Early Alzheimer’S Disease

Alzheimer's disease is likely to be one of the challenges for the early part of the 21st century. Better knowledge of the molecular biology, genetics and pathogenesis of the condition have led to a host of psychopharmacological compounds being developed which may help in its the treatment, while epidemiological studies have suggested that existing treatments for other chronic conditions may have an effect on the presentation of Alzheimer's disease.

Chapter 22. Ethnic and Racial Differences in The Pathophysiology of Alzheimer's Disease

2022 ◽  
pp. 608-659
Author(s):  
Pavani Rekulapally ◽  
Lakshmi Garimella ◽  
Saravanan Krishnan ◽  
N. Ashwin Kumar ◽  
S. N. Suresh
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Racial Differences

Perceived Stress is Associated with Alzheimer’s Disease Cerebrospinal Fluid Biomarkers in African Americans with Mild Cognitive Impairment

2020 ◽  
Vol 77 (2) ◽  
pp. 843-853
Author(s):  
Antoine R. Trammell ◽  
Darius J. McDaniel ◽  
Malik Obideen ◽  
Maureen Okafor ◽  
Tiffany L. Thomas ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cerebrospinal Fluid ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
African Americans ◽  
Racial Differences ◽  
Perceived Stress ◽  
Cross Sectional Study ◽  
Cross Sectional

Background: African Americans (AA) have a higher Alzheimer’s disease (AD) prevalence and report more perceived stress than White Americans. The biological basis of the stress-AD link is unclear. This study investigates the connection between stress and AD biomarkers in a biracial cohort. Objective: Establish biomarker evidence for the observed association between stress and AD, especially in AA. Methods: A cross-sectional study (n = 364, 41.8% AA) administering cognitive tests and the perceived stress scale (PSS) questionnaire. A subset (n = 309) provided cerebrospinal fluid for measurement of Aβ42, Tau, Ptau, Tau/Aβ42 (TAR), and Ptau/Aβ42 (PTAR). Multivariate linear regression, including factors that confound racial differences in AD, was performed. Results: Higher PSS scores were associated with higher Ptau (β= 0.43, p = 0.01) and PTAR (β= 0.005, p = 0.03) in AA with impaired cognition (mild cognitive impairment). Conclusion: Higher PSS scores were associated with Tau-related AD biomarker indices in AA/MCI, suggesting a potential biological connection for stress with AD and its racial disparity.

P3-006: Racial Differences in Willingness to Enroll in Preclinical Alzheimer's Disease Clinical Trials

2016 ◽  
Vol 12 ◽  
pp. P819-P820
Author(s):  
Yan Zhou ◽  
David Elashoff ◽  
Sarah Kremen ◽  
Edmond Teng ◽  
Jason Karlawish ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Clinical Trials ◽  
Racial Differences ◽  
Preclinical Alzheimer’S Disease

scholarly journals Racial differences in biomarkers of Alzheimer’s disease and inflammation

2021 ◽  
Vol 17 (S5) ◽  
Author(s):  
William T. Hu ◽  
Whitney Wharton ◽  
Monica W. Parker
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Racial Differences

scholarly journals Racial Differences in the Pathway to Diagnosis of Alzheimer's Disease and Related Dementias

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 280-280
Author(s):  
James Burke ◽  
Matthew Dupre ◽  
Se Hee Min ◽  
Ruth Anderson ◽  
David Page ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Racial Differences ◽  
Primary Diagnosis ◽  
Health Records ◽  
Black And White ◽  
Clinical Encounters ◽  
To Receive ◽  
Hispanic White

Abstract This study examined differences in the pathway to diagnosis of Alzheimer's disease and related dementias (ADRD) between Black and White older adults. Using electronic health records from a large health system, we included 2,085 non-Hispanic Black and 6,269 non-Hispanic White older adults with a final/primary diagnosis of ADRD between 2014 and 2020. Black older adults were more likely to receive the ADRD diagnosis from a primary care provider (35.4% vs. 29.8%), during a hospital admission (19.5% vs. 13.6%), or during an emergency department visit (4.2% vs. 2.0%); but were less likely to be diagnosed by an ADRD specialist (31.6% vs. 45.2%). Black older adults had nearly twice as many clinical encounters in the two years prior to the ADRD diagnosis than their White counterparts (43 vs. 26). Despite having more clinical encounters, Black older adults were more likely to be at a later stage when diagnosed than White older adults.

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