Association of Race and Income with Incident Diagnosis of Alzheimer’s Disease and Related Dementias among Black and White Older Adults

Laura M. Keohane; Sayeh Nikpay; Kyle Braun; Audrey Cheng; David Stevenson; Melinda B. Buntin; Danxia Yu; William J. Blot; Loren Lipworth

doi:10.1177/07334648221142851

Association of Race and Income with Incident Diagnosis of Alzheimer’s Disease and Related Dementias among Black and White Older Adults

Laura M. Keohane, Sayeh Nikpay, Kyle Braun, Audrey Cheng, David Stevenson, Melinda B. Buntin, Danxia Yu, William J. Blot, Loren Lipworth

Health Policy and Management

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4 Scopus citations

Abstract

To investigate how differences in income and education levels may contribute to disparities in incidence of Alzheimer’s disease and related dementia (ADRD), we compared ADRD incidence in traditional Medicare claims for 11,132 Black and 7703 White participants aged 65 and over from a predominantly low-income cohort. We examined whether the relationship between ADRD incidence and race varied by income or education. Based on 2015 incident ADRD diagnoses, Black and White participants had unadjusted incidence rates of 26.5 and 23.2 cases per 1000 person-years, respectively (rate ratio 1.14, 95% CI 1.05–1.25). In multivariable Cox proportional hazard models, the relationship between race and incident ADRD diagnosis did not vary by education level (p-interaction = 0.748) but was modified by income level (p-interaction = 0.007), with higher ADRD incidence among Black participants observed only among higher income groups. These results highlight the importance of understanding how race and economic factors influence ADRD incidence and diagnosis rates.

Original language	English (US)
Pages (from-to)	898-908
Number of pages	11
Journal	Journal of Applied Gerontology
Volume	42
Issue number	5
DOIs	https://doi.org/10.1177/07334648221142851
State	Published - May 2023

Bibliographical note

Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Research reported in this publication was supported by the National Cancer Institute of the National Institutes of Health under Award Number U01CA202979, including a supplement for research related to Alzheimer’s disease and related dementias (3U01CA202979-03S1). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. SCCS data collection was performed by the Survey and Biospecimen Shared Resource which is supported in part by the Vanderbilt-Ingram Cancer Center (P30 CA68485).

Publisher Copyright:
© The Author(s) 2022.

Keywords

Alzheimer’s disease
dementia
incidence
income
race

PubMed: MeSH publication types

Journal Article
Research Support, N.I.H., Extramural

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10.1177/07334648221142851

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title = "Association of Race and Income with Incident Diagnosis of Alzheimer{\textquoteright}s Disease and Related Dementias among Black and White Older Adults",

abstract = "To investigate how differences in income and education levels may contribute to disparities in incidence of Alzheimer{\textquoteright}s disease and related dementia (ADRD), we compared ADRD incidence in traditional Medicare claims for 11,132 Black and 7703 White participants aged 65 and over from a predominantly low-income cohort. We examined whether the relationship between ADRD incidence and race varied by income or education. Based on 2015 incident ADRD diagnoses, Black and White participants had unadjusted incidence rates of 26.5 and 23.2 cases per 1000 person-years, respectively (rate ratio 1.14, 95% CI 1.05–1.25). In multivariable Cox proportional hazard models, the relationship between race and incident ADRD diagnosis did not vary by education level (p-interaction = 0.748) but was modified by income level (p-interaction = 0.007), with higher ADRD incidence among Black participants observed only among higher income groups. These results highlight the importance of understanding how race and economic factors influence ADRD incidence and diagnosis rates.",

keywords = "Alzheimer{\textquoteright}s disease, dementia, incidence, income, race",

author = "Keohane, {Laura M.} and Sayeh Nikpay and Kyle Braun and Audrey Cheng and David Stevenson and Buntin, {Melinda B.} and Danxia Yu and Blot, {William J.} and Loren Lipworth",

note = "Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Research reported in this publication was supported by the National Cancer Institute of the National Institutes of Health under Award Number U01CA202979, including a supplement for research related to Alzheimer{\textquoteright}s disease and related dementias (3U01CA202979-03S1). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. SCCS data collection was performed by the Survey and Biospecimen Shared Resource which is supported in part by the Vanderbilt-Ingram Cancer Center (P30 CA68485). Publisher Copyright: {\textcopyright} The Author(s) 2022.",

year = "2023",

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doi = "10.1177/07334648221142851",

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AU - Cheng, Audrey

AU - Stevenson, David

AU - Buntin, Melinda B.

AU - Yu, Danxia

AU - Blot, William J.

AU - Lipworth, Loren

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PY - 2023/5

Y1 - 2023/5

N2 - To investigate how differences in income and education levels may contribute to disparities in incidence of Alzheimer’s disease and related dementia (ADRD), we compared ADRD incidence in traditional Medicare claims for 11,132 Black and 7703 White participants aged 65 and over from a predominantly low-income cohort. We examined whether the relationship between ADRD incidence and race varied by income or education. Based on 2015 incident ADRD diagnoses, Black and White participants had unadjusted incidence rates of 26.5 and 23.2 cases per 1000 person-years, respectively (rate ratio 1.14, 95% CI 1.05–1.25). In multivariable Cox proportional hazard models, the relationship between race and incident ADRD diagnosis did not vary by education level (p-interaction = 0.748) but was modified by income level (p-interaction = 0.007), with higher ADRD incidence among Black participants observed only among higher income groups. These results highlight the importance of understanding how race and economic factors influence ADRD incidence and diagnosis rates.

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Association of Race and Income with Incident Diagnosis of Alzheimer’s Disease and Related Dementias among Black and White Older Adults

Abstract

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