دورية أكاديمية
أعرض في EDS

Racial disparities among older adults with acute myocardial infarction: The SILVER-AMI study.

التفاصيل البيبلوغرافية
العنوان: Racial disparities among older adults with acute myocardial infarction: The SILVER-AMI study.
المؤلفون: Demkowicz PC; Department of Internal Medicine, Section of General Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA., Hajduk AM; Department of Internal Medicine, Section of Geriatrics, Yale University School of Medicine, New Haven, Connecticut, USA., Dodson JA; Department of Medicine, Division of Cardiology, NYU Grossman School of Medicine, New York, New York, USA.; Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA., Oladele CR; Department of Internal Medicine, Section of General Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA.; Equity Research and Innovation Center, Yale University School of Medicine, New Haven, Connecticut, USA., Chaudhry SI; Department of Internal Medicine, Section of General Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA.
المصدر: Journal of the American Geriatrics Society [J Am Geriatr Soc] 2023 Feb; Vol. 71 (2), pp. 474-483. Date of Electronic Publication: 2022 Nov 23.
نوع المنشور: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: Blackwell Science Country of Publication: United States NLM ID: 7503062 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-5415 (Electronic) Linking ISSN: 00028614 NLM ISO Abbreviation: J Am Geriatr Soc Subsets: MEDLINE
أسماء مطبوعة: Publication: Malden, MA : Blackwell Science
Original Publication: New York [etc.]
مواضيع طبية MeSH: Activities of Daily Living* , Myocardial Infarction*/ethnology , Health Status Disparities*, Female ; Humans ; Male ; Hospitalization ; Hospitals ; United States/epidemiology ; Black or African American ; White
مستخلص: Background: Despite an aging population, little is known about racial disparities in aging-specific functional impairments and mortality among older adults hospitalized for acute myocardial infarction (AMI).
Methods: We analyzed data from patients aged 75 years or older who were hospitalized for AMI at 94 US hospitals from 2013 to 2016. Functional impairments and geriatric conditions were assessed in-person during the AMI hospitalization. The association between race and risk of mortality (primary outcome) was evaluated with logistic regression adjusted sequentially for age, clinical characteristics, and measures of functional impairment and other conditions associated with aging.
Results: Among 2918 participants, 2668 (91.4%) self-identified as White and 250 (8.6%) as Black. Black participants were younger (80.8 vs 81.7 years; p = 0.010) and more likely to be female (64.8% vs 42.5%; p < 0.001). Black participants were more likely to present with impairments in cognition (37.6% vs 14.5%; p < 0.001), mobility (66.0% vs 54.6%; p < 0.001) and vision (50.1% vs 35.7%; p < 0.001). Black participants were also more likely to report a disability in one or more activities of daily living (22.4% vs 13.0%; p < 0.001) and an unintentional loss of more than 10 lbs in the year prior to hospitalization (37.2% vs 13.0%; p < 0.001). The unadjusted odds of 6-month mortality among Black participants (odds ratio [OR] 2.0, 95% confidence interval [CI] 1.4-2.8) attenuated to non-significance after adjustment for age, clinical characteristics (OR 1.70, 95% CI 1.7, 1.2-2.5), and functional/geriatric conditions (OR 1.5, 95% CI 1.0-2.2).
Conclusions: Black participants had a more geriatric phenotype despite a younger average age, with more functional impairments. Controlling for functional impairments and geriatric conditions attenuated disparities in 6-month mortality somewhat. These findings highlight the importance of systematically assessing functional impairment during hospitalization and also ensuring equitable access to community programs to support post-AMI recovery among Black older adults.
(© 2022 The American Geriatrics Society.)
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معلومات مُعتمدة: T35 HL007649 United States HL NHLBI NIH HHS; UL1 TR001863 United States TR NCATS NIH HHS; P30 AG021342 United States AG NIA NIH HHS; R01 HL115295 United States HL NHLBI NIH HHS
فهرسة مساهمة: Keywords: Black/African American; acute myocardial infarction; functional impairment; health care disparities; race
تواريخ الأحداث: Date Created: 20221123 Date Completed: 20230222 Latest Revision: 20240202
رمز التحديث: 20240202
مُعرف محوري في PubMed: PMC9957871
DOI: 10.1111/jgs.18084
PMID: 36415964
قاعدة البيانات: MEDLINE
الوصف
تدمد:1532-5415
DOI:10.1111/jgs.18084