PDF(Pubmed)
Abstract：
African American/Black communities comprise 12.2% of the U.S. population, with a COVID-19 infection rate of more than 18% and marginal access to healthcare services. This scoping review synthesizes the emerging evidence on healthcare accessibility among older African American adult communities with dementia and COVID-19, as well as the resource requirements for this population during the pandemic. Searches of different databases for empirical studies and other sources on dementia and COVID-19 among older African American adults yielded 13 studies that met the following inclusion criteria: (a) focus on dementia and COVID-19, (b) sampled older African American adults, (c) investigated healthcare accessibility and resources, and (d) published between 2019 and 2022. Following the initial selection of the studies, eight were selected for relevance based on the Population, Concept, and Context (PCC) inclusion and exclusion criteria. Thematic analysis indicated that older African Americans with dementia and COVID-19 experienced longer delays in accessing timely healthcare, including transportation, intensive care units (ICUs), and mechanical ventilation. They also had reduced healthcare resources associated with a lack of health insurance, low financial resources, and an increased length of hospital stay, which further aggravated the negative effects of comorbid dementia and COVID-19 infections. Evidence showed that racial and age disparities affected older African American adults with dementia and COVID-19, resulting in lower healthcare access and marginal resources. This is consistent with historical and systemic inequities in meeting the healthcare needs of people of color in the United States, which was compounded for older African Americans during the COVID-19 pandemic.
摘要：
非洲裔美国人/黑人社区占美国人口的12.2％，COVID-19感染率超过18%，获得医疗服务的机会很少。这项范围审查综合了患有痴呆症和COVID-19的非洲裔美国老年成人社区的医疗保健可及性的新证据，以及大流行期间该人群的资源需求。在不同的数据库中搜索关于老年非裔美国成年人痴呆症和COVID-19的实证研究和其他来源，得出了13项符合以下纳入标准的研究：(a)关注痴呆症和COVID-19，(b)抽样的老年非裔美国成年人，(c)调查医疗保健的可及性和资源，和（d）在2019年至2022年之间发布。在初步选择研究之后，根据人口的相关性选择了8个，概念,和背景(PCC)纳入和排除标准。主题分析表明，患有痴呆症和COVID-19的老年非裔美国人在获得及时医疗保健方面经历了更长的延误，包括交通,重症监护病房（ICU），机械通气。他们还减少了与缺乏医疗保险相关的医疗保健资源，财力低,以及住院时间的增加,这进一步加剧了痴呆和COVID-19感染的共病负面影响。有证据表明，种族和年龄差异影响了患有痴呆症和COVID-19的老年非洲裔美国成年人，导致更低的医疗保健机会和边际资源。这与满足美国有色人种医疗保健需求的历史和系统性不平等是一致的，在COVID-19大流行期间，老年非裔美国人的病情加重。
