High Rates of Native Hawaiian and Older Japanese Adults Hospitalized with Dementia in Hawai‘i

Abstract

Limited data exist on dementia in Native Hawaiians and many Asian subgroups in the United States. Inpatients with dementia have higher costs, longer stays, and higher mortality compared to those without dementia. This study compared the rates of inpatients with a dementia diagnosis for disaggregated Asian and Pacific Islanders (Native Hawaiian, Chinese, Japanese, Filipino) vs. White by age group (18-59, 60-69, 70-79, 80-89 and 90+ years) for all adult patients hospitalized in Hawai'i between December 2006 and December 2010. A total of 13,465 in patients with a dementia diagnosis were identified by ICD-9 codes. Rates were calculated using population size denominators derived from the US Census. Across all age categories, Native Hawaiians had the highest unadjusted rates of inpatients with dementia and were hospitalized with a dementia diagnosis at younger ages than other racial/ethnic groups. In adjusted models compared to Whites (controlling for gender, residence location, and insurer), Native Hawaiians had significantly higher rates of inpatients with dementia among those 18-59 years (aRR:1.50;95%CI:0.84-2.69), 60-69 years (aRR:2.53;95%CI:1.74-3.68), 70-79 years(aRR:2.19;95%CI:1.78-2.69) and 80-89 years (aRR:2.53;95%CI:1.24-1.71) as did Japanese aged 70-79 years (aRR:1.30;95%CI:1.01-1.67), 80-89 years (aRR:1.29;95%CI:1.05-1.57) and 90+ years (aRR:1.51;95%CI:1.24-1.85). Japanese aged 18-59 years had significantly lower rates than Whites (aRR:0.40; 95%CI:0.17-0.94).These patterns have important public health and clinical care implications for Native Hawaiians and older Japanese populations. Future studies should consider if preventable medical risk, care giving, socio-economic conditions, genetic disposition, or a combination of these factors are responsible for these findings.

Inequalities in dementia incidence between six racial and ethnic groups over 14 years

“…Our findings differ from the limited research on dementia in these populations. A recent hospital-based study estimated higher dementia rates among Native Hawaiians and Japanese Americans compared with Whites in Hawaii [37]. A small cross-sectional study reported low prevalence of dementia among Cree living on reservations in Northern Manitoba, Canada [38].…”

Prevalence of Selected Chronic Conditions Among Children, Adolescents, and Young Adults in Acute Care Settings in Hawai‘i

“…Race/ethnicity was self-reported primary race/ethnicity at intake and was consistently collected across all hospitals in Hawaiʻi following standardized protocols and quality assurance ( 23 ). For those who provided multiple races/ethnicities, we followed a standard protocol ( 24 ).…”

Alzheimer’s Disease and its Related Dementias among Asian Americans, Native Hawaiians, and Pacific Islanders: A Scoping Review

“…A large number of retrospective studies showed a relationship between mid-life vascular conditions (e.g., high systolic blood pressure) and late-life dementia [33,41,57,69,71,72,76,79,82,87,90], with the impact of vascular conditions observed roughly 25 years later [67,72,81,87]. Lower body mass index (BMI) and slower decline in BMI were associated with reduced risk of dementia [58,65].…”