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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Differential Impact of Index Stroke on Dementia Risk in African-Americans Compared to Whites
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Differential Impact of Index Stroke on Dementia Risk in African-Americans Compared to Whites

机译：与白人相比，指数中风对非裔美国人痴呆风险的差异影响

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ObjectiveTo compare whites and African-Americans in terms of dementia risk following index stroke. MethodsThe data consisted of billing and International Classification of Diseases, Ninth Revision diagnosis codes from the South Carolina Revenue and Fiscal Affairs office on all hospital discharges within the state between 2000 and 2012. The sample consisted of 68,758 individuals with a diagnosis of ischemic stroke prior to 2010 (49,262 white [71.65%] and 19,496 African-Americans [28.35%]). We identified individuals in the dataset who were subsequently diagnosed with any of 5 categories of dementia and evaluated time to dementia diagnosis in Cox Proportional Hazards models. We plotted cumulative hazard curves to illustrate the effect of race on dementia risk after controlling for age, sex, and occurrence of intervening stroke. ResultsAge at index stroke was significantly different between the 2 groups, with African-Americans being younger on average (70.0 [SD 12.5] in whites versus 64.5 [SD 14.1] in African-Americans,P< .0001). Adjusted hazard ratios revealed that African-American race increased risk for all 5 categories of dementia following incident stroke, ranging from 1.37 for AD to 1.95 for vascular dementia. Age, female sex, and intervening stroke likewise increased risk for dementia. ConclusionsAfrican-Americans are at higher risk for dementia than whites within 5 years of ischemic stroke, regardless of dementia subtype. Incident strokes may have a greater likelihood of precipitating dementia in African-Americans due to higher prevalence of nonstroke cerebrovascular disease or other metabolic or vascular factors that contribute to cognitive impairment.
机译：目的比较白人和非裔美国人在中风后痴呆风险方面的差异。方法数据包括2000年至2012年间南卡罗来纳州收入和财政事务办公室关于该州所有医院出院的账单和国际疾病分类、第九版诊断代码。样本包括68758名在2010年之前被诊断为缺血性中风的个体（49262名白人[71.65%]和19496名非裔美国人[28.35%]）。我们在数据集中确定了随后被诊断患有5种痴呆症的个体，并用Cox比例风险模型评估了痴呆症诊断的时间。我们绘制了累积风险曲线，以说明在控制年龄、性别和干预性中风发生率后，种族对痴呆风险的影响。结果两组患者的中风指数年龄有显著差异，非裔美国人的平均年龄较年轻（白人为70.0[SD 12.5]，非裔美国人为64.5[SD 14.1]，P<0.0001）。调整后的危险比显示，非裔美国人种族增加了中风后所有5类痴呆症的风险，从AD的1.37到血管性痴呆的1.95不等。年龄、女性性别和干预性中风同样会增加患痴呆症的风险。结论无论痴呆亚型如何，在缺血性卒中的5年内，南非裔美国人比白人更容易患痴呆。由于非中风性脑血管疾病或其他导致认知损害的代谢或血管因素的患病率较高，偶发性中风可能更容易在非裔美国人中诱发痴呆症。

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