Role of Geography on Alzheimer’s Disease and Related Dementias in Central Appalachia

地理对阿巴拉契亚中部阿尔茨海默病和相关痴呆症的影响

基本信息

批准号：
10509690
负责人：
Jeffrey James Wing
金额：
$ 7.4万
依托单位：
OHIO STATE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-08-15 至 2024-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10509690
关键词：
Address Age Alzheimer&apos s Disease Alzheimer&apos s disease diagnosis Alzheimer&apos s disease related dementia Alzheimer&apos s disease risk American American Medical Association Appalachian Region Area Attenuated Automobile Driving Binomial Model Caring Censuses Characteristics Community Surveys Country County Data Data Aggregation Data Set Data Sources Dementia Detection Diagnosis Diagnostic Disease Education Ethnic Origin Geographic Locations Geography Health Services Accessibility High Prevalence Housing Image Incidence Intervention Investigation Lead Measures Modeling Neurologist Ohio Pattern Patterns of Care Policies Population Prevalence Primary Care Physician Principal Investigator Proxy Publishing Race Reporting Research Personnel Resources Role Rural Rural Appalachia Scanning United States Centers for Medicare and Medicaid Services Variant Work beneficiary burden of illness comorbidity data resource demographics experience geographic difference geographic disparity health care quality health care service improved innovation multiple data sources prognostic programs racial and ethnic regional difference rural area rural counties rural dwellers sociodemographic factors sociodemographics urban area

项目摘要

Project Summary/Abstract Geographic variation in Alzheimer’s disease and related dementias (ADRD) prevalence exists, but the mechanisms driving these disparities remain unknown. The two most likely and non-exclusive explanations for geographic variation in ADRD are: 1. disparities in patterning of sociodemographic factors (e.g. rural residents may be at a greater risk of ADRD due to lower educational attainment) and/or 2. differences in disease detection rates (e.g. rural residents may have reduced access to and quality of health care services and thus fewer dementia diagnoses regardless of the true prevalence). As rural areas have lower reported ADRD prevalence compared to urban areas in spite of lower educational attainment (which should lead to higher ADRD prevalence) this argues that the true burden of ADRD in likely underestimated in areas without adequate detection resources. There is need to understand if ADRD prevalence is truly lower in rural areas, or if this is a disease detection difference. The objective of this proposal is to assess the burden of ADRD in Central Appalachia. By using geographic characteristics to assess the association between geographic variation, socio-demographic factors, and access to care (e.g. primary care physicians (PCPs), neurologists) we will understand how patterns of care influence ADRD diagnoses and which parts of the country may have relatively over- or underestimated ADRD prevalence due to differences in care intensity. 1. We will verify regional differences in ADRD prevalence across the Central Appalachian region using stratified negative binomial regression models. Working hypothesis: Rural counties will have lower ADRD prevalence, as will Appalachian counties relative to urban and non-Appalachian counties, respectively. 2. Socio-demographic and access to care factors will be included in existing negative binomial models to assess their contribution to regional differences in ADRD prevalence. Working hypothesis: socio-demographic and access factors partially explain/attenuate variations in ADRD prevalence. This proposal addresses the objectives of PAS-19-391 in several ways: 1. The Principal Investigator (PI) is an early stage investigator committed to ADRD; 2. The PI has experience with using CMS data, census data, and other existing aggregate data sources; and 3. The PI has published using these data in describing geographic differences in ADRD prevalence in Ohio. This project would represent the next step in better understanding of regional differences in ADRD prevalence and provide critical data toward the role of access to care in estimating ADRD prevalence.

项目概要/摘要阿尔茨海默病和相关痴呆症 (ADRD) 患病率存在地域差异，但造成这些差异的机制仍然未知，两种最有可能且非排他性的解释。 ADRD 的地理差异包括： 1. 社会人口因素模式的差异（例如，由于受教育程度较低，可能会面临更高的 ADRD 风险）和/或 2. 疾病差异检测率（例如，农村居民获得医疗保健服务的机会和质量可能会降低，因此无论真实的患病率如何，痴呆症的诊断都较少），因为农村地区报告的 ADRD 较低。与城市地区相比，尽管受教育程度较低（这应该会导致更高的患病率） ADRD 患病率）这表明，在没有 ADRD 的地区，ADRD 的真正负担可能被低估了需要了解农村地区 ADRD 患病率是否确实较低，或者如果这是疾病检测差异，则该提案的目的是评估 ADRD 的负担。中部阿巴拉契亚通过使用地理特征来评估地理之间的关联。变异、社会人口因素和获得护理的机会（例如初级保健医生 (PCP)、神经科医生）我们将了解护理模式如何影响 ADRD 诊断以及该国的哪些地区可能患有 ADRD 由于护理强度的差异，ADRD 患病率相对高估或低估 1. 我们将核实。使用分层负数分析阿巴拉契亚中部地区 ADRD 患病率的区域差异二项式回归模型：农村县的 ADRD 患病率较低。阿巴拉契亚县分别相对于城市县和非阿巴拉契亚县 2. 社会人口和人口。获得护理因素的机会将被纳入现有的负二项式模型中，以评估其对 ADRD 患病率的地区差异：部分社会人口和获取因素。解释/减弱 ADRD 患病率的变化该提案解决了 PAS-19-391 的目标。有几种方式： 1. 首席研究员 (PI) 是致力于 ADRD 的早期研究员； 2. PI 具有使用 CMS 数据、人口普查数据和其他现有汇总数据源的经验；以及 3. PI 已发表使用这些数据来描述俄亥俄州 ADRD 患病率的地理差异的项目。将代表更好地了解 ADRD 患病率的区域差异的下一步，并提供关于获得护理在估计 ADRD 患病率方面的作用的关键数据。