Ethnic Differences in Dementia Risk: A Systematic Review and Meta-Analysis

Background: Globally around 50 million people have dementia. Risk factors for dementia such as hypertension and diabetes are more common in Black, Asian, and other ethnic minorities. There are also marked ethnic inequalities in care seeking, likelihood of diagnosis, and uptake of treatments for dementia. Nevertheless, ethnic differences in dementia incidence and prevalence remain under-explored. Objective: To examine published peer-reviewed observational studies comparing age-specific or age-adjusted incidence or prevalence rates of dementia between at least two ethnic groups. Methods: We searched seven databases on 1 September 2019 using search terms for ethnicity, dementia, and incidence or prevalence. We included population-based studies comparing incidence or prevalence of dementia after accounting for age of at least two ethnic groups in adults aged 18 or more. Meta-analysis was conducted for eligible ethnic comparisons. Results: We included 12 cohort studies and seven cross-sectional studies. Thirteen were from the US, and two studies each from the UK, Singapore, and Xinjiang Uyghur Autonomous Region in China. The pooled risk ratio for dementia incidence obtained from four studies comparing Black and White ethnic groups was 1.33 (95% CI 1.07–1.65; I-squared = 58.0%). The pooled risk ratio for dementia incidence comparing the Asian and White ethnic groups was 0.86 (95% CI 0.728–1.01; I-squared = 43.9%). There was no difference in the incidence of dementia for Latino ethnic group compared to the White ethnic group. Conclusion: Evidence to date suggest there are ethnic differences in risk of dementia. Better understanding of the drivers of these differences may inform efforts to prevent or treat dementia.

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Study of canthal index in Nepalese undergraduate medical students of BPKIHS, Nepal: gender and ethnic differences

Journal of Kathmandu Medical College ◽

10.3126/jkmc.v3i2.11231 ◽

2014 ◽

Vol 3 (2) ◽

pp. 78-81

Author(s):

Sandip Shah ◽

Sarun Koirala

Keyword(s):

Ethnic Groups ◽

Undergraduate Students ◽

Ethnic Differences ◽

Cross Sectional Study ◽

Male Students ◽

Undergraduate Medical Students ◽

Cross Sectional ◽

Clinical Anthropology ◽

Standard Values ◽

Different Genetic Background

Background: Craniofacial anthropometry is a technique used in both physical and clinical anthropology comprising precise and systematic measurements of the human skull. It also includes measurement of the medial and lateral canthal distances. People of different genetic background subjected to significantly different environmental influences have different craniofacial morphology.Objectives: To find out effect of gender and ethnicity on Canthal anthropometry.Methods: This descriptive cross-sectional study was carried out to determine and compare canthal anthropometry among 299 undergraduate students (Male=161, Female=138) of different ethnic groups (Indo-Nepalese, indigenous and Tibeto-Nepalese) of age group 19-21 years at BPKIHS. Medial and lateral canthal distances were measured by using straight vernier caliper and canthal index (medial canthal distances / lateral canthal distance × 100) for all three ethnic groups in both sexes were compared.Results: The study has shown that the female students had higher canthal index than male students (27.65±12.35 vs 23.96±5.76). When compared on the basis of ethnicity, Indo-Nepalese had highest value of canthal index followed by Indigenous and Tibeto-Nepalese.Conclusion: In conclusion, genetics and environmental factors are responsible for the variation in canthal indices and other craniofacial indices between and within populations. Therefore, its standard values are largely applicable for clinical assessment of patients with syndrome affecting canthal anatomy.DOI: http://dx.doi.org/10.3126/jkmc.v3i2.11231Journal of Kathmandu Medical CollegeVol. 3, No. 2, Issue 8, Apr.-Jun., 2014Page: 78-81

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Ethnic Differences in Antipsychotic treatment responses in Early Intervention in Psychosis

The Physician ◽

10.38192/1.7.1.6 ◽

2021 ◽

Vol 7 (1) ◽

pp. 1-8

Author(s):

Nandini Chakraborty ◽

Shiraz Ahmed ◽

Hannah Booth ◽

Hawa Aswat

Keyword(s):

Early Intervention ◽

Ethnic Group ◽

Ethnic Groups ◽

Ethnic Differences ◽

Antipsychotic Treatment ◽

Electronic Patient Records ◽

Treatment Responses ◽

Ethnic Variations ◽

Early Intervention In Psychosis ◽

Best Responses

Background Ethnic variations in pathways to early intervention in psychosis (EIP) have been studied. However, it is important to explore the ethnic variations in response to pharmacological treatment in EIP. Aims To look at ethnic variation in response to antipsychotics. Method Electronic patient records in December 2018 were perused for: Sociodemographic details including ethnicity Prescribed antipsychotic and dosage to which the patient had responded Results White, Black and Asian ethnic groups responded mostly to Olanzapine. The largest proportion of the mixed ethnic group responded to Aripiprazole. The White and Asian groups showed the best responses to Lurasidone at 74 mg. There was a slight response in the mixed and other ethnic groups only at the higher dose of 111 mg. The medication has not been used with any benefit in the Black ethnic group. Conclusion The complex differences highlighted amongst ethnic responses to treatment make a case for multi-centric studies to further explore ethnic differences in early intervention treatments. This will help streamline offered treatments to maximise response in EIP.

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SARS-CoV-2 antibody prevalence and determinants of six ethnic groups living in Amsterdam, the Netherlands: a population-based cross-sectional study, June-October 2020

10.1101/2021.03.08.21252788 ◽

2021 ◽

Author(s):

Liza Coyer ◽

Anders Boyd ◽

Janke Schinkel ◽

Charles Agyemang ◽

Henrike Galenkamp ◽

...

Keyword(s):

The Netherlands ◽

Ethnic Groups ◽

South Asian ◽

Ethnic Differences ◽

Population Based ◽

Cross Sectional Study ◽

Antibody Prevalence ◽

Calendar Time ◽

Cross Sectional ◽

Small Children

AbstractBackgroundEthnic minorities have higher rates of SARS-CoV-2 diagnoses, but little is known about ethnic differences in past exposure. We aimed to determine whether prevalence and determinants of SARS-CoV-2 exposure varied between six ethnic groups in Amsterdam, the Netherlands.MethodsParticipants aged 25-79 years enrolled in a population-based prospective cohort were randomly selected within ethnic groups and invited to test for SARS-CoV-2-specific antibodies and answer COVID-19 related questions. We estimated prevalence and determinants of SARS-CoV-2 exposure within ethnic groups using survey-weighted logistic regression adjusting for age, sex and calendar time.ResultsBetween June 24-October 9, 2020, we included 2497 participants. Adjusted SARS-CoV-2 seroprevalence was comparable between ethnic-Dutch (25/498; 5.5%, 95%CI=3.2-7.9), South-Asian Surinamese (22/451; 4.8%, 95%CI=2.1-7.5), African Surinamese (22/400; 8.2%, 95%CI=3.0-13.4), Turkish (30/408; 7.8%, 95%CI=4.3-11.2) and Moroccan (32/391; 7.0%, 95%CI=4.0-9.9) participants, but higher among Ghanaians (95/327; 26.5%, 95%CI=18.7-34.4). 57.1% of SARS-CoV-2-positive participants did not suspect or were unsure of being infected, which was lowest in African Surinamese (18.2%) and highest in Ghanaians (90.5%). Determinants of SARS-CoV-2 exposure varied across ethnic groups, while the most common determinant was having a household member suspected of infection. In Ghanaians, seropositivity was associated with older age, larger household sizes, living with small children, leaving home to work and attending religious services.ConclusionsNo remarkable differences in SARS-CoV-2 seroprevalence were observed between the largest ethnic groups in Amsterdam after the first wave of infections. The higher infection seroprevalence observed among Ghanaians, which passed mostly unnoticed, warrants wider prevention efforts and opportunities for non-symptom-based testing.

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Ethnic differences in jealousy in Surinam

Journal of Social and Personal Relationships ◽

10.1177/0265407519880287 ◽

2019 ◽

Vol 37 (4) ◽

pp. 1136-1149

Author(s):

Abraham P. Buunk ◽

Pieternel Dijkstra ◽

Glenn Leckie ◽

Dascha Dipokarto

Keyword(s):

Ethnic Group ◽

Ethnic Groups ◽

Ethnic Differences ◽

Cultural Influences ◽

Demographic Variables ◽

Sexual Relationships ◽

Total N ◽

Future Studies ◽

Mixed Groups

The present study examined differences in three types of jealousy (reactive, anxious, and preventive jealousy) between the major ethnic groups in Surinam (Maroons, Creoles, Hindustani, Javanese, and Mixed). About 100 participants from each ethnic group (total n = 500) were interviewed. Results showed differences between the groups in anxious and preventive jealousy, but not in reactive jealousy. More specifically, Maroons reported most anxious and preventive jealousy, followed by Creoles, and Javanese. The Hindustani and Mixed groups reported the lowest levels of anxious and preventive jealousy. These results did not alter after controlling for demographic variables. In addition, differences in jealousy could not be explained by differences between the groups in intrasexual competitiveness and attitudes toward multiple sexual relationships. Findings suggest that whereas preventive jealousy and anxious jealousy are sensitive to cultural influences, reactive jealousy is not. Future studies may further explore the variables that may explain differences in jealousy between ethnic groups in Surinam.

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Trends in Cigar Use in the United States, 2002–2016: Diverging Trends by Race/Ethnicity

Nicotine & Tobacco Research ◽

10.1093/ntr/ntz060 ◽

2019 ◽

Vol 22 (4) ◽

pp. 583-587 ◽

Cited By ~ 1

Author(s):

Andrea H Weinberger ◽

Cristine D Delnevo ◽

Jiaqi Zhu ◽

Misato Gbedemah ◽

Joun Lee ◽

...

Keyword(s):

United States ◽

Black Women ◽

Ethnic Group ◽

Ethnic Groups ◽

Ethnic Differences ◽

Mixed Race ◽

The United States ◽

Race Ethnicity ◽

Racial Ethnic ◽

Over Time

Abstract Introduction Although there are racial/ethnic differences in cigarette use, little is known about how non-cigarette tobacco use differs among racial/ethnic groups. This study investigated trends in cigar use from 2002 to 2016, by racial/ethnic group, in nationally representative US data. Methods Data were drawn from the 2002–2016 National Survey on Drug Use and Health public use data files (total analytic sample n = 630 547 including 54 060 past-month cigar users). Linear time trends of past-month cigar use were examined by racial/ethnic group (Non-Hispanic [NH] White, NH Black, Hispanic, NH Other/Mixed Race/Ethnicity) using logistic regression models. Results In 2016, the prevalence of past-month cigar use was significantly higher among NH Black respondents than among other racial/ethnic groups (ps < .001). Cigar use was also higher among NH White respondents than among Hispanic and NH Other/Mixed Race/Ethnicity respondents. The year by racial/ethnic group interaction was significant (p < .001). Past-month cigar use decreased significantly from 2002 to 2016 among NH White and Hispanic respondents (ps = .001), whereas no change in prevalence was observed among NH Black (p = .779) and NH Other/Mixed Race/Ethnicity respondents (p = .152). Cigar use decreased for NH White men (p < .001) and did not change for NH White women (p = .884). Conversely, cigar use increased for NH Black women (p < .001) and did not change for NH Black men (p = .546). Conclusions Cigar use remains significantly more common among NH Black individuals in the United States and is not declining among NH Black and NH Other/Mixed Race/Ethnicity individuals over time, in contrast to declines among NH White and Hispanic individuals. Implications This study identified racial/ethnic differences in trends in past-month cigar use over 15 years among annual cross-sectional samples of US individuals. The highest prevalence of cigar use in 2016 was found among NH Black individuals. In addition, cigar use prevalence did not decline from 2002 to 2016 among NH Black and NH Other/Mixed Race/Ethnicity groups over time, in contrast to NH White and Hispanic groups. Further, cigar use increased over time for NH Black women. Targeted public health and clinical efforts may be needed to decrease the prevalence of cigar use, especially for NH Black individuals.

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Dementia Risk Following Ischemic Stroke: A Systematic Review and Meta-Analysis of Factors Collected at Time of Stroke Diagnosis

10.1101/2021.10.28.21265621 ◽

2021 ◽

Author(s):

Reem Waziry ◽

Jacqueline J Claus ◽

Albert Hofman

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Meta Analysis ◽

Hospital Setting ◽

Incidence Rates ◽

Previous Stroke ◽

Dementia Risk ◽

Dementia Incidence ◽

Stroke Diagnosis

Objective: To assess incidence rates and predictors of dementia after ischemic stroke. Methods: A search was conducted on Embase and Medline for reports published up to November 2019. Studies were included if they: 1) assessed dementia incidence among patients with ischemic stroke diagnosis and 2) excluded patients with prevalent dementia at baseline. The main analysis included: 1) absolute risk; 2) incidence rates (per 100 person-years) and 3) patient-level predictors (demographics, CVD history and major cardiac events, previous stroke and TIA, stroke location, disability post-stroke, chronic brain change and stroke mechanism). Additional predictors assessed included study setting (clinic or registry), method of dementia diagnosis (Diagnostic and Statistical Manual of Mental Disorders (DSM), National Institute of Neurological Disorders and Stroke (NINDS) or both) and inclusion of patients with recurrent or first-ever stroke. A random effects meta-analysis was undertaken. Risk of bias in included studies was assessed in terms of selection, comparability and outcome. Results: 4,325 studies were screened in the title and abstract phase after removing duplicates and 280 eligible studies were screened for full text. A total of 21 studies met the inclusion criteria and were included in the meta-analysis, representing 55,183 patients with ischemic stroke, with average age of 70 years (range 65-80 years) and average follow-up of 29 months. The majority of included studies were conducted in a hospital setting (n=17/21). The overall rate of dementia after ischemic stroke was 13.0 per 1000 person-years (95% CI 6.0, 36.0). Incidence rates were eight times higher in hospital-based studies (17.0, 95% CI 8.0, 36.0) compared to registry-based studies (1.8, 95% CI 0.8, 4.0). Absolute dementia risk after stroke was 20% at 5 year, 30% at 15 years and 48% at 25 years of follow-up. Incidence rates were 1.5 times higher in studies that included patients with recurrent ischemic stroke compared to estimates from studies that included first-time ever stroke patients only. There was 33% difference in dementia incidence in the later study periods (2007-2009) compared to (1996-2006). Statistically significant predictors of dementia after ischemic stroke included female gender (OR=1.2, 95% CI 1.1, 1.4), hypertension (1.4, 95% 1.1, 2.0), diabetes mellitus (1.6, 95% 1.3, 2.1), atrial fibrillation (1.9, 95% 1.2, 3.0), previous stroke (2.0, 95% CI 1.6, 2.6), presence of stroke lesion in dominant hemisphere (2.4, 95% 1.3, 4.5), brain stem/cerebellum (0.5, 95% CI 0.3, 0.9) or frontal lobe (3.7, 95% CI 1.2, 12.0), presence of aphasia (7.9, 95% CI 2.4, 26.0), dysphasia (5.8, 95% CI 3.0, 11.3), gait impairment (1.7, 95% CI 1.1, 2.7), presence of white matter hyperintensities (3.2, 95% CI 2.0, 5.3), medial temporal lobe atrophy (3.9, 95% CI 1.9, 8.3) and transient ischemic attack (TIA) as the predisposing aetiology for ischemic stroke (0.44, 95% CI 0.22, 0.88). Conclusion: Factors routinely collected at time of admission guide informed monitoring of patients at highest risk of progression to dementia after acute ischemic stroke. Predictors of dementia after acute ischemic stroke should be assessed as distinct features from those established for general dementia.

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Crime and Perceived Neighborhood Safety Across Racial-Ethnic Groups

Innovation in Aging ◽

10.1093/geroni/igab046.1318 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 342-342

Author(s):

Alfredo Velasquez ◽

Fangqi Guo ◽

Jennifer Robinette

Keyword(s):

Ethnic Groups ◽

Ethnic Differences ◽

Household Wealth ◽

Ethnic Heterogeneity ◽

Neighborhood Safety ◽

Cross Sectional ◽

Safety Concerns ◽

Study Results ◽

Racial Ethnic ◽

Perceived Neighborhood Safety

Abstract Crime often increases safety concerns for residents, and safety concerns are generally associated with worse health. Despite that marginalized racial/ethnic groups are more likely than non-Hispanic Whites to live in areas with more crime, prior studies have documented that these groups differentially view crime as a threat to safety. Furthermore, older adults are more likely to report safety concerns than younger adults, despite a lesser chance of being victimized. Using multiple waves of data from the Health and Retirement Study, a representative sample of US adults aged 51 years and older (n= 11,161, mean age of 66 years), we conducted weighted repeated cross-sectional linear regressions to examine whether the association between crime and perceived neighborhood safety varies by racial/ethnic group, by age, or by wave of data collection. Study results indicated that higher crime rates consistently predicted more safety concerns among non-Hispanic Whites, Hispanics, and “Others,” but were inconsistently associated with safety concerns among non-Hispanic Blacks, adjusting for age, household wealth, and census tract-level concentrated disadvantage, population density, and racial/ethnic heterogeneity. Furthermore, among non-Hispanic Whites, greater crime predicted more safety concerns before, but not after including a measure of racial/ethnic heterogeneity. These patterns persisted across the full age span. Racial/ethnic differences in the crime-safety link could be explained by additional sociopolitical and environmental variables including diversity that vary over time. Follow-up analysis is needed to determine if the racial/ethnic differences in crime-safety links extend to health.

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Antiherpetic medication and incident dementia: observational cohort studies in four countries

10.1101/2020.12.03.20241497 ◽

2020 ◽

Author(s):

Christian Schnier ◽

Janet Janbek ◽

Linda Williams ◽

Tim Wilkinson ◽

Thomas Munk Laursen ◽

...

Keyword(s):

Cohort Studies ◽

Meta Analysis ◽

Short Term ◽

Dementia Risk ◽

Incident Dementia ◽

Dementia Incidence ◽

Specific Medication ◽

Observational Cohort ◽

Time Dependent Covariates ◽

Dementia Subtype

IntroductionRecent meta-analysis of the association between herpesvirus infection and dementia concluded that the evidence for an association to date is insufficient.Methods2.5 million individuals aged ≥65 years were followed up using linked electronic health records in four national observational cohort studies. Exposure and outcome were classified using coded data from primary and secondary care. Data were analyzed using survival analysis with time-dependent covariates.ResultsResults were heterogeneous, with a tendency towards decreased dementia risk in individuals exposed to antiherpetic medication. Associations were not affected by treatment number, herpes subtype, dementia subtype, or specific medication. In one cohort, individuals diagnosed with herpes but not exposed to antiherpetic medication were at higher dementia risk.DiscussionShort-term antiherpetic medication is not markedly associated with incident dementia. Because neither dementia subtype nor herpes subtype modified the association, the small but significant decrease in dementia incidence with antiherpetic adminstration may reflect confounding and misclassification.

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Pathways to, and use of, sexual healthcare among Black Caribbean sexual health clinic attendees in England: evidence from cross-sectional bio-behavioural surveys

BMC Health Services Research ◽

10.1186/s12913-019-4396-3 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Catherine R. H. Aicken ◽

Sonali Wayal ◽

Paula B. Blomquist ◽

Stella M. Fabiane ◽

Makeda Gerressu ◽

...

Keyword(s):

Sexual Health ◽

Ethnic Groups ◽

Ethnic Differences ◽

Online Survey ◽

Service Use ◽

Health Clinic ◽

Symptom Duration ◽

Care Seeking ◽

Black Caribbean ◽

Sexual Healthcare

Abstract Background In England, people of Black Caribbean (BC) ethnicity are disproportionately affected by sexually transmitted infections (STI). We examined whether differences in sexual healthcare behaviours contribute to these inequalities. Methods We purposively selected 16 sexual health clinics across England with high proportions of attendees of BC ethnicity. During May–September 2016, attendees at these clinics (of all ethnicities) completed an online survey that collected data on health service use and sexual behaviour. We individually linked these data to routinely-collected surveillance data. We then used multivariable logistic regression to compare reported behaviours among BC and White British/Irish (WBI) attendees (n = 627, n = 1411 respectively) separately for women and men, and to make comparisons by gender within these ethnic groups. Results BC women’s sexual health clinic attendances were more commonly related to recent bacterial STI diagnoses, compared to WBI women’s attendances (adjusted odds ratio, AOR 3.54, 95% CI 1.45–8.64, p = 0.009; no gender difference among BC attendees), while BC men were more likely than WBI men (and BC women) to report attending because of a partner’s symptoms or diagnosis (AOR 1.82, 95% CI 1.14–2.90; AOR BC men compared with BC women: 4.36, 95% CI 1.42–13.34, p = 0.014). Among symptomatic attendees, BC women were less likely than WBI women to report care-seeking elsewhere before attending the sexual health clinic (AOR 0.60, 95% CI 0.38–0.97, p = 0.039). No ethnic differences, or gender differences among BC attendees, were observed in symptom duration, or reporting sex whilst symptomatic. Among those reporting previous diagnoses with or treatment for bacterial STI, no differences were observed in partner notification. Conclusions Differences in STI diagnosis rates observed between BC and WBI ethnic groups were not explained by the few ethnic differences which we identified in sexual healthcare-seeking and use. As changes take place in service delivery, prompt clinic access must be maintained – and indeed facilitated – for those at greatest risk of STI, regardless of ethnicity.

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Ethnicity and sexual risk in heterosexual people attending sexual health clinics in England: a cross-sectional, self-administered questionnaire study

Sexually Transmitted Infections ◽

10.1136/sextrans-2017-053308 ◽

2018 ◽

Vol 94 (5) ◽

pp. 384-391 ◽

Cited By ~ 5

Author(s):

Rachel Margaret Coyle ◽

Ada Rose Miltz ◽

Fiona C Lampe ◽

Janey Sewell ◽

Andrew N Phillips ◽

...

Keyword(s):

Sexual Health ◽

Ethnic Groups ◽

Sexual Risk ◽

Heterosexual Men ◽

Risk Behaviours ◽

Cross Sectional ◽

Caribbean Women ◽

White Ethnic ◽

Self Administered Questionnaire ◽

Sexual Risk Behaviours

ObjectivesIn the UK, people of black ethnicity experience a disproportionate burden of HIV and STI. We aimed to assess the association of ethnicity with sexual behaviour and sexual health among women and heterosexual men attending genitourinary medicine (GUM) clinics in England.MethodsThe Attitudes to and Understanding of Risk of Acquisition of HIV is a cross-sectional, self-administered questionnaire study of HIV negative people recruited from 20 GUM clinics in England, 2013–2014. Modified Poisson regression with robust SEs was used to calculate adjusted prevalence ratios (aPR) for the association between ethnicity and various sexual risk behaviours, adjusted for age, study region, education and relationship status.ResultsQuestionnaires were completed by 1146 individuals, 676 women and 470 heterosexual men. Ethnicity was recorded for 1131 (98.8%) participants: 550 (48.6%) black/mixed African, 168 (14.9%) black/mixed Caribbean, 308 (27.2%) white ethnic groups, 105 (9.3%) other ethnicity. Compared with women from white ethnic groups, black/mixed African women were less likely to report condomless sex with a non-regular partner (aPR (95% CI) 0.67 (0.51 to 0.88)), black/mixed African and black/mixed Caribbean women were less likely to report two or more new partners (0.42 (0.32 to 0.55) and 0.44 (0.29 to 0.65), respectively), and black/mixed Caribbean women were more likely to report an STI diagnosis (1.56 (1.00 to 2.42)). Compared with men from white ethnic groups, black/mixed Caribbean men were more likely to report an STI diagnosis (1.91 (1.20 to 3.04)), but did not report risk behaviours more frequently. Men and women of black/mixed Caribbean ethnicity remained more likely to report STI history after adjustment for sexual risk behaviours.DiscussionRisk behaviours were reported less frequently by women of black ethnicity; however, history of STI was more prevalent among black/mixed Caribbean women. In black/mixed Caribbean men, higher STI history was not explained by ethnic variation in reported risk behaviours. The association between STI and black/mixed Caribbean ethnicity remained after adjustment for risk behaviours.

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