Abstract：
UNASSIGNED: Black and Hispanic older adults have greater incidence of Alzheimer\'s disease and related dementias relative to White adults, but factors underlying these disparities are not well understood, limiting the ability to address them.
UNASSIGNED: To determine the impact of demographics, cardiovascular disease (CVD) and risk factors, social determinants of health (SDOH), and neuropsychiatric risk factors on racial/ethnic disparities in dementia risk among Veterans.
UNASSIGNED: We examined a random sample of 1,579,919 older Veterans (age ≥55) without dementia who received care from the VHA from October 1, 1999 to September 30, 2021. All variables were extracted from national VHA data. We used Cox proportional hazard regression models to examine change in variance in risk of dementia across racial/ethnic groups.
UNASSIGNED: During follow up (mean 11.1 years), 13% of Veterans developed dementia. Relative to White Veterans, the adjusted hazard ratios (AHRs) for developing dementia in sex-adjusted models with age as timescale were 1.65 (95% CI, 1.63-1.67) for Black Veterans and 1.50 (95% CI, 1.44-1.56) for Hispanic Veterans. In the model examining CVD and risk factors, AHRs were 1.53 (95% CI, 1.50-1.55) for Black Veterans and 1.38 (95% CI, 1.33-1.44) for Hispanic Veterans. In the model examining SDOH, AHRs were 1.46 (95% CI, 1.43-1.49) for Black Veterans and 1.34 (95% CI, 1.29-1.40) for Hispanic Veterans.
UNASSIGNED: SDOH and CVD and risk factors accounted for the greatest amount of variance in racial/ethnic disparities in dementia risk. Cardiovascular disease and SDOH are strong possible targets for interventions designed to reduce these disparities.
UNASSIGNED: To determine the impact of demographics, cardiovascular disease (CVD) and risk factors, social determinants of health (SDOH), and neuropsychiatric risk factors on racial/ethnic disparities in dementia risk among Veterans.
UNASSIGNED: We examined a random sample of 1,579,919 older Veterans (age ≥55) without dementia who received care from the VHA from October 1, 1999 to September 30, 2021. All variables were extracted from national VHA data. We used Cox proportional hazard regression models to examine change in variance in risk of dementia across racial/ethnic groups.
UNASSIGNED: During follow up (mean 11.1 years), 13% of Veterans developed dementia. Relative to White Veterans, the adjusted hazard ratios (AHRs) for developing dementia in sex-adjusted models with age as timescale were 1.65 (95% CI, 1.63-1.67) for Black Veterans and 1.50 (95% CI, 1.44-1.56) for Hispanic Veterans. In the model examining CVD and risk factors, AHRs were 1.53 (95% CI, 1.50-1.55) for Black Veterans and 1.38 (95% CI, 1.33-1.44) for Hispanic Veterans. In the model examining SDOH, AHRs were 1.46 (95% CI, 1.43-1.49) for Black Veterans and 1.34 (95% CI, 1.29-1.40) for Hispanic Veterans.
UNASSIGNED: SDOH and CVD and risk factors accounted for the greatest amount of variance in racial/ethnic disparities in dementia risk. Cardiovascular disease and SDOH are strong possible targets for interventions designed to reduce these disparities.
摘要：
■黑人和西班牙裔老年人相对于白人成年人，阿尔茨海默病和相关痴呆的发病率更高，但是这些差异背后的因素还没有得到很好的理解，限制了解决这些问题的能力。
■要确定人口统计的影响，心血管疾病（CVD）和危险因素，健康的社会决定因素(SDOH)，和神经精神危险因素对退伍军人痴呆症风险种族/族裔差异的影响。
■我们从1999年10月1日至2021年9月30日接受VHA护理的1,579,919名没有痴呆症的老年退伍军人（年龄≥55岁）的随机样本。所有变量均从国家VHA数据中提取。我们使用Cox比例风险回归模型来检查不同种族/族裔痴呆症风险的变化。
■随访期间（平均11.1年），13％的退伍军人患有痴呆症。相对于白人退伍军人，在以年龄为时间尺度的性别校正模型中,黑人退伍军人患痴呆的校正风险比(AHR)为1.65(95%CI,1.63~1.67),西班牙裔退伍军人患痴呆的校正风险比为1.50(95%CI,1.44~1.56).在检查CVD和危险因素的模型中，黑人退伍军人的AHR为1.53（95％CI，1.50-1.55），西班牙裔退伍军人为1.38（95％CI，1.33-1.44）。在检查SDOH的模型中，黑人退伍军人的AHR为1.46（95％CI，1.43-1.49），西班牙裔退伍军人为1.34（95％CI，1.29-1.40）。
■SDOH和CVD和危险因素在痴呆风险中种族/民族差异差异最大。心血管疾病和SDOH是旨在减少这些差异的干预措施的重要可能目标。
■要确定人口统计的影响，心血管疾病（CVD）和危险因素，健康的社会决定因素(SDOH)，和神经精神危险因素对退伍军人痴呆症风险种族/族裔差异的影响。
■我们从1999年10月1日至2021年9月30日接受VHA护理的1,579,919名没有痴呆症的老年退伍军人（年龄≥55岁）的随机样本。所有变量均从国家VHA数据中提取。我们使用Cox比例风险回归模型来检查不同种族/族裔痴呆症风险的变化。
■随访期间（平均11.1年），13％的退伍军人患有痴呆症。相对于白人退伍军人，在以年龄为时间尺度的性别校正模型中,黑人退伍军人患痴呆的校正风险比(AHR)为1.65(95%CI,1.63~1.67),西班牙裔退伍军人患痴呆的校正风险比为1.50(95%CI,1.44~1.56).在检查CVD和危险因素的模型中，黑人退伍军人的AHR为1.53（95％CI，1.50-1.55），西班牙裔退伍军人为1.38（95％CI，1.33-1.44）。在检查SDOH的模型中，黑人退伍军人的AHR为1.46（95％CI，1.43-1.49），西班牙裔退伍军人为1.34（95％CI，1.29-1.40）。
■SDOH和CVD和危险因素在痴呆风险中种族/民族差异差异最大。心血管疾病和SDOH是旨在减少这些差异的干预措施的重要可能目标。
