Evidence map›Paper›PMID 34459392›Full record

ArticleJournal of Alzheimer's disease : JAD2021

Dementia Care in Diverse Older Adults in the U.S. Deep South and the Rest of the United States.

Maria Pisu, Roy C Martin, Liang Shan, Giovanna Pilonieta, Richard E Kennedy, Gabriela Oates, Young-Il Kim, David S Geldmacher

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of Alzheimer's disease : JAD, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
1.1field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Maria PisuDivision of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
Roy C MartinAlzheimer's Disease Center, University of Alabama at Birmingham, Birmingham, AL, USA.
Liang ShanDivision of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
Giovanna PilonietaDepartment of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA.
Richard E KennedyAlzheimer's Disease Center, University of Alabama at Birmingham, Birmingham, AL, USA.
Gabriela OatesDepartment of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USA.
Young-Il KimDivision of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
David S GeldmacherAlzheimer's Disease Center, University of Alabama at Birmingham, Birmingham, AL, USA.
University of Alabama at Birmingham · US

Funding

RESEARCH TRAINING COREP60MD000502 · NIMHD · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI FOUAD, MONA N. · 2003 to 2016
$16.2M
Project 2: Leveraging Ongoing Home Visitation Programs to Address Obesity Disparities among Underserved, Low-Income Mothers and ChildrenU54MD000502 · NIMHD · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI FOUAD, MONA N., GARVEY, W TIMOTHY · 2017 to 2022
$11.8M
UAB Alzheimer's Disease Research CenterP20AG068024 · NIA · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI ROBERSON, ERIK D · 2020 to 2022
$3.3M
NIA NIH HHS P20 AG068024NIMHD NIH HHS P60 MD000502NIMHD NIH HHS U54 MD000502
6 · The paper itself

Abstract

backgroundUse of specialists and recommended drugs has beneficial effects for older adults living with Alzheimer's disease and related dementia (ADRD). Gaps in care may exist for minorities, e.g., Blacks, and especially in the United States (U.S.) Deep South (DS), a poor U.S. region with rising ADRD cases and minority overrepresentation. Currently, we have little understanding of ADRD care utilization in diverse populations in this region and elsewhere in the U.S. (non-DS), and the factors that adversely impact it.

objectiveTo examine utilization of specialists and ADRD drugs (outcomes) in racial/ethnic groups of older adults with ADRD and the personal or context-level factors affecting these outcomes in DS and non-DS.

methodsWe obtained outcomes and personal-level covariates from claims for 127,512 Medicare beneficiaries with ADRD in 2013-2015, and combined county-level data in exploratory factor analysis to define context-level covariates. Adjusted analyses tested significant association of outcomes with Black/White race and other factors in DS and non-DS.

resultsAcross racial/ethnic groups, 33%-43% in DS and 43%-50% in non-DS used specialists; 47%-55% in DS and 41%-48% in non-DS used ADRD drugs. In adjusted analyses, differences between Blacks and Whites were not significant. Vascular dementia, comorbidities, poverty, and context-level factor "Availability of Medical Resources" were associated with specialist use; Alzheimer's disease and senile dementia, comorbidities, and specialist use were associated with drug use. In non-DS only, other individual, context-level covariates were associated with the outcomes.

conclusionWe did not observe significant gaps in ADRD care in DS and non-DS; however, research should further examine determinants of low specialist and drug use in these regions.

Indexed as

DementiaHealthcare DisparitiesRacial GroupsAgedFemaleHealth Services AccessibilityHumansMaleMedicareRetrospective StudiesSocioeconomic FactorsSoutheastern United StatesSpecializationUnited StatesAccess to careaffordabilitydisparitiesdrug useequityphysician availabilitysocioeconomic context, socioeconomic statusspecialist use

Identifiers

PMID34459392
PMCPMC8843111
OpenAlexW3194681994

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.