Racial, ethnic, and rural disparities in distance to physicians among decedents with Alzheimer's disease and related dementias in Washington State

Amiri, Solmaz; Keffeler, Jonae I.; Crain, Dennis R.; Denney, Justin T.; Buchwald, Dedra

doi:10.1002/alz.13756

Cited by 2 publications

(1 citation statement)

References 38 publications

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“…A higher prevalence of obesity, medical comorbidity, and health disparities appears to underlie this difference ( Woods et al, 2015 ). A recent study including American Indians, Alaska Natives, Hispanics, and non-Hispanic White older adults with ADRD in Washington State highlighted that difficulty accessing healthcare may explain some of the health disparities ( Amiri et al, 2024 ). The relationship between sleep disorders, cognition and race is complex and likely involves multiple genetic, behavioral and environmental factors.…”

Section: Discussionmentioning

confidence: 99%

Mid-life sleep is associated with cognitive performance later in life in aging American Indians: data from the Strong Heart Study

Fonseca,

Finlay,

Chaytor

et al. 2024

Front. Aging Neurosci.

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BackgroundSleep-related disorders have been associated with cognitive decline and neurodegeneration. American Indians are at increased risk for dementia. Here, we aim to characterize, for the first time, the associations between sleep characteristics and subsequent cognitive performance in a sample of aging American Indians.MethodsWe performed analyses on data collected in two ancillary studies from the Strong Heart Study, which occurred approximately 10 years apart with an overlapping sample of 160 American Indians (mean age at follow-up 73.1, standard deviation 5.6; 69.3% female and 80% with high school completion). Sleep measures were derived by polysomnography and self-reported questionnaires, including sleep timing and duration, sleep latency, sleep stages, indices of sleep-disordered breathing, and self-report assessments of poor sleep and daytime sleepiness. Cognitive assessment included measures of general cognition, processing speed, episodic verbal learning, short and long-delay recall, recognition, and phonemic fluency. We performed correlation analyses between sleep and cognitive measures. For correlated variables, we conducted separate linear regressions. We analyzed the degree to which cognitive impairment, defined as more than 1.5 standard deviations below the average Modified Mini Mental State Test score, is predicted by sleep characteristics. All regression analyses were adjusted for age, sex, years of education, body mass index, study site, depressive symptoms score, difference in age from baseline to follow-up, alcohol use, and presence of APOE e4 allele.ResultsWe found that objective sleep characteristics measured by polysomnography, but not subjective sleep characteristics, were associated with cognitive performance approximately 10 years later. Longer sleep latency was associated with worse phonemic fluency (β = −0.069, p = 0.019) and increased likelihood of being classified in the cognitive impairment group later in life (odds ratio 1.037, p = 0.004). Longer duration with oxygen saturation < 90% was associated with better immediate verbal memory, and higher oxygen saturation with worse total learning, short and long-delay recall, and processing speed.ConclusionIn a sample of American Indians, sleep characteristics in midlife were correlated with cognitive performance a decade later. Sleep disorders may be modifiable risk factors for cognitive impairment and dementia later in life, and suitable candidates for interventions aimed at preventing neurodegenerative disease development and progression.

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Section: Discussionmentioning

confidence: 99%

Mid-life sleep is associated with cognitive performance later in life in aging American Indians: data from the Strong Heart Study

Fonseca,

Finlay,

Chaytor

et al. 2024

Front. Aging Neurosci.

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Representing the Needs of Rural Caregivers of People Living With Alzheimer’s Disease and Related Dementias Through User Personas

Jolliff,

Hill,

Zuraw

et al. 2024

Innovation in Aging

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Background and Objectives Rural caregivers of people living with Alzheimer’s disease and related dementias (ADRD) face unique caregiving challenges. Current interventions do not address many of the systemic barriers experienced by rural ADRD caregivers, including barriers related to geography, healthcare services access, and financial insecurity. The objective of this study was to gain a deeper understanding of rural ADRD caregivers’ needs, strengths, and strategies in obtaining caregiving support, and to represent these attributes in the form of personas that can be used to design interventions for rural ADRD caregivers. Research Design and Methods In this qualitative user-centered design study, we conducted semi-structured interviews with self-identified caregivers of people living with ADRD in rural areas. Interview data was copied to a virtual whiteboard, and affinity diagramming was used to confirm a priori attributes and yield inductive attributes relevant to rural ADRD caregivers. Attributes were assigned to personas, which were then validated through team-based discussion, consultation with a study advisory board, and review by rural caregivers and community partners. Results Analyses of N=19 interviews yielded seven inductive attributes relevant to rural ADRD caregivers of persons living with ADRD and five distinct personas: Capable Christine, Connected Connie, Isolated Irene, Learning Larry, and Discerning Dan. Personas differed on inductive attributes including financial security, subjective rurality, attitudes, connectedness, and information behavior, including preferences for traditional versus technology-based information seeking. Discussion and Implications The personas identified in the present study can be used as tools to represent and efficiently communicate the intersection and interaction of attributes relevant to designing interventions and technologies to meet the support needs of rural ADRD caregivers.

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Racial, ethnic, and rural disparities in distance to physicians among decedents with Alzheimer's disease and related dementias in Washington State

Cited by 2 publications

References 38 publications

Mid-life sleep is associated with cognitive performance later in life in aging American Indians: data from the Strong Heart Study

Mid-life sleep is associated with cognitive performance later in life in aging American Indians: data from the Strong Heart Study

Representing the Needs of Rural Caregivers of People Living With Alzheimer’s Disease and Related Dementias Through User Personas

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