Health disparities in aging: Improving dementia care for Black women

Findley, Caleigh A; Cox, MaKayla F.; Lipson, Adam B.; Bradley, RaTasha; Hascup, Kevin N.; Yuede, Carla M.; Hascup, Erin R.

doi:10.3389/fnagi.2023.1107372

Cited by 9 publications

(6 citation statements)

References 46 publications

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“…We observed that Black patients with AD were more likely to be hospitalized during the COVID-19 pandemic. This finding is consistent with prior reports that race was a risk factor in acute care utilization [ 31 , 39 ]. For example, compared to White patients, Black patients with AD had increased odds of Emergency Department (ED) visits and hospitalizations [ 40 ].…”

Section: Discussionsupporting

confidence: 93%

Characteristics of Older Adults with Alzheimer’s Disease Who Were Hospitalized during the COVID-19 Pandemic: A Secondary Data Analysis

Wang,

Hendrix,

Lee

et al. 2024

IJERPH

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We aim to investigate the relationships between the population characteristics of patients with Alzheimer’s Disease (AD) and their Healthcare Utilization (HU) during the COVID-19 pandemic. Electronic health records (EHRs) were utilized. The study sample comprised those with ICD-10 codes G30.0, G30.1, G30.8, and G30.9 between 1 January 2020 and 31 December 2021. Pearson’s correlation and multiple regression were used. The analysis utilized 1537 patient records with an average age of 82.20 years (SD = 7.71); 62.3% were female. Patients had an average of 1.64 hospitalizations (SD = 1.18) with an average length of stay (ALOS) of 7.45 days (SD = 9.13). Discharge dispositions were primarily home (55.1%) and nursing facilities (32.4%). Among patients with multiple hospitalizations, a negative correlation was observed between age and both ALOS (r = −0.1264, p = 0.0030) and number of hospitalizations (r = −0.1499, p = 0.0004). Predictors of longer ALOS included male gender (p = 0.0227), divorced or widowed (p = 0.0056), and the use of Medicare Advantage and other private insurance (p = 0.0178). Male gender (p = 0.0050) and Black race (p = 0.0069) were associated with a higher hospitalization frequency. We recommend future studies including the co-morbidities of AD patients, larger samples, and longitudinal data.

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Section: Discussionsupporting

confidence: 93%

Characteristics of Older Adults with Alzheimer’s Disease Who Were Hospitalized during the COVID-19 Pandemic: A Secondary Data Analysis

Wang,

Hendrix,

Lee

et al. 2024

IJERPH

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“…It may enhance or possibly replace immunotherapy in some who are so afflicted. Relief would flow to women (LC/T1DM87/other autoimmune diseases), especially those of color (AA [136], psoriasis [137], vitiligo [138], AD [139], T2DM [140]).…”

Section: Discussionmentioning

confidence: 99%

Long Covid, the Gut, and Autoimmune Skin Diseases: A Novel Therapeutic Approach

W. Chambers

2024

JNNS

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The dermatological manifestations of Long Covid (LC) have languished in the shadows of chronic fatigue and brain fog. Yet they are all linked by gut dysbiosis and the cytokine triad of TNF-α, IL-1β, and IL-6. The gut microbiome common not only to LC, psoriasis, AA, and vitiligo but also to neurodegenerative disease has been recently described. This gut microbiome induces an altered tryptophan metabolism linked to autoimmune disease. SARS CoV2, Mycobacteria, and many intestinal parasites protectively upregulate IFN-γ (less Covid in BCG and in subSaharan Africa), triggering the characteristic altered tryptophan metabolism and curtailing synthesis of serotonin and melatonin. Chronic inflammation due to persistent spike protein S exhausts IFN-γ and leads to gut dysbiosis and autoimmune risk. Butyrate immunomodulates IFN-γ and TGF-β, which counterbalance each other (reciprocal relationship). Low IFN-γ (LC) translates to high TGF-β (organ fibrosis). This review suggests that an etiologic prebiotic (d-mannose)/probiotic (lactobacilli, bifidobacteria)/postbiotic (butyrate) approach to autoimmune skin disease that improves intestinal barrier integrity and that suppresses the triad of TNF-α, IL-6, and IL-1β may enhance or even eliminate the traditional immunotherapy of targeted monoclonal antibodies, Janus kinase inhibitors, and steroids. Health benefits of this approach extend well beyond suppression of autoimmune skin disease. Societal benefits include relief to those most affected - women (LC), especially of color (AA, psoriasis, vitiligo).

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“…This highlights the critical need to consider the role of sex and gender, as well as the use of exogenous hormones, throughout the spectrum of ADRDs, from prevention to detection and treatment. Similarly, studies did not consider race and ethnicity, even though Black women are at the highest risk for ADRD (56). These will be important demographic data points for future studies to consider.…”

Section: Discussionmentioning

confidence: 99%

Hormonal contraception and risk for cognitive impairment or Alzheimer's disease and related dementias in young women: a scoping review of the evidence

Gregory,

Booi,

Jenkins

et al. 2023

Front. Glob. Womens Health

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IntroductionWomen are significantly more likely to develop Alzheimer's disease and related dementias (ADRD) than men. Suggestions to explain the sex differences in dementia incidence have included the influence of sex hormones with little attention paid to date as to the effect of hormonal contraception on brain health. The aim of this scoping review is to evaluate the current evidence base for associations between hormonal contraceptive use by women and non-binary people in early adulthood and brain health outcomes.MethodsA literature search was conducted using EMBASE, Medline and Google Scholar, using the keywords “hormonal contraception” OR “contraception” OR “contraceptive” AND “Alzheimer*” OR “Brain Health” OR “Dementia”.ResultsEleven papers were identified for inclusion in the narrative synthesis. Studies recruited participants from the UK, USA, China, South Korea and Indonesia. Studies included data from women who were post-menopausal with retrospective data collection, with only one study contemporaneously collecting data from participants during the period of hormonal contraceptive use. Studies reported associations between hormonal contraceptive use and a lower risk of ADRD, particularly Alzheimer's disease (AD), better cognition and larger grey matter volume. Some studies reported stronger associations with longer duration of hormonal contraceptive use, however, results were inconsistent. Four studies reported no significant associations between hormonal contraceptive use and measures of brain health, including brain age on MRI scans and risk of AD diagnosis.DiscussionFurther research is needed on young adults taking hormonal contraceptives, on different types of hormonal contraceptives (other than oral) and to explore intersections between sex, gender, race and ethnicity.Systematic Review Registrationhttps://doi.org/10.17605/OSF.IO/MVX63, identifier: OSF.io: 10.17605/OSF.IO/MVX63

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Health disparities in aging: Improving dementia care for Black women

Cited by 9 publications

References 46 publications

Characteristics of Older Adults with Alzheimer’s Disease Who Were Hospitalized during the COVID-19 Pandemic: A Secondary Data Analysis

Characteristics of Older Adults with Alzheimer’s Disease Who Were Hospitalized during the COVID-19 Pandemic: A Secondary Data Analysis

Long Covid, the Gut, and Autoimmune Skin Diseases: A Novel Therapeutic Approach

Hormonal contraception and risk for cognitive impairment or Alzheimer's disease and related dementias in young women: a scoping review of the evidence

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