Τίτλος:
Dementia in People from Ethnic Minority Backgrounds: Disability,
Functioning, and Pharmacotherapy at the Time of Diagnosis
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Objectives: Increasingly, older populations in the United Kingdom and
other well-resourced settings are ethnically diverse. Despite a concern
that the prevalence of dementia is expected to rise, very little is
known about the association of ethnicity and dementia among aging older
adults. The current study aimed to compare ethnic group differences in
symptom profile, functioning and pharmacotherapy at dementia diagnosis.
Design: Cross-sectional study of patient characteristics at the point of
dementia diagnosis.
Setting and Participants: In total, 12,154 patients aged 65 years or
older diagnosed with dementia in Southeast London between 2007 and 2015.
Methods: Data were extracted from the Clinical Record Interactive Search
system, which provides anonymized access to the electronic health
records of a large mental healthcare provider in Southeast London.
Patients from ethnic minority backgrounds were compared with white
British individuals on mental and physical well-being, functional scales
and medications prescribed at dementia diagnosis, as well as subtype of
dementia documented anywhere in the record.
Results: Compared with white British patients, Black African and Black
Caribbean patients were more likely to present with psychotic symptoms
and were less likely to have an antidepressant prescribed; white Irish
patients had higher rates of substance/alcohol use and depressive
symptoms were more prevalent in South Asian patients; all ethnic
minority groups had higher odds of polypharmacy; and vascular dementia
diagnoses were more common in Black and Irish ethnic minority groups.
Conclusions and Implications: At dementia diagnosis, there are
substantial differences in noncognitive mental health symptoms and
pharmacotherapy across ethnic minority groups and compared with the
white British majority population. Some of these differences might
reflect access/treatment inequalities or implicit unconscious bias
related to ethnicity, influencing both. They need to be taken into
consideration to optimize pathways into care and personalize assessment
and management. (C) 2020 AMDA - The Society for Post-Acute and Long-Term
Care Medicine.
Συγγραφείς:
Tsamakis, Konstantinos
Gadelrab, Romayne
Wilson, Mimi and
Bonnici-Mallia, Anne M.
Hussain, Labib
Perera, Gayan
Rizos,
Emmanouil
Das-Munshi, Jayati
Stewart, Robert
Mueller,
Christoph
Περιοδικό:
Journal of the American Medical Directors Association
Εκδότης:
EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
Λέξεις-κλειδιά:
Dementia; ethnic minorities; psychosis; polypharmacy; vascular dementia;
antidepressants; health inequalities
DOI:
10.1016/j.jamda.2020.06.026
