2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association

Circulation, Journal Year: 2024, Volume and Issue: 149(8)

Published: Jan. 24, 2024

BACKGROUND: The American Heart Association (AHA), in conjunction with the National Institutes of Health, annually reports most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, nutrition, sleep, obesity) factors (cholesterol, blood pressure, glucose control, metabolic syndrome) that contribute health. AHA Disease Stroke Statistical Update presents latest data on a range major clinical circulatory disease conditions (including brain health, complications pregnancy, kidney congenital rhythm disorders, sudden cardiac arrest, subclinical atherosclerosis, coronary cardiomyopathy, failure, valvular venous thromboembolism, peripheral artery disease) associated outcomes quality care, procedures, economic costs). METHODS: AHA, through its Epidemiology Prevention Statistics Committee, continuously monitors evaluates sources stroke United States globally provide current information available annual review published literature year before writing. 2024 is product full year’s worth effort 2023 by dedicated volunteer clinicians scientists, committed government professionals, staff members. strives further understand help heal problems inflicted structural racism, public crisis can significantly damage mental perpetuate disparities access education, income, housing, several other vital healthy lives. This edition includes additional global data, as well monitoring benefits population, an enhanced focus equity across key domains. RESULTS: Each chapters focuses different topic statistics. CONCLUSIONS: represents critical resource for lay public, policymakers, media clinicians, care administrators, researchers, advocates, others seeking best these conditions.

Language: Английский

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Plasma GFAP, NfL and pTau 181 detect preclinical stages of dementia

Frontiers in Endocrinology, Journal Year: 2024, Volume and Issue: 15

Published: April 9, 2024

Background Plasma biomarkers are preferable to invasive and expensive diagnostic tools, such as neuroimaging lumbar puncture that gold standard in the clinical management of Alzheimer’s Disease (AD). Here, we investigated plasma Glial Fibrillary Acidic Protein (GFAP), Neurofilament Light Chain (NfL) Phosphorylated-tau-181 (pTau 181) AD its early stages: Subjective cognitive decline (SCD) Mild impairment (MCI). Material methods This study included 152 patients (42 SCD, 74 MCI 36 AD). All underwent comprehensive neurological assessment. Blood samples were collected for Apolipoprotein E (APOE) genotyping biomarker (GFAP, NfL, pTau measurements. Forty-three (7 27 MCI, 9 AD) a follow-up (FU) visit after 2 years, second sample was collected. levels detected using Simoa SR-X technology (Quanterix Corp.). Statistical analysis performed SPSS software version 28 (IBM Statistics). significance set at p < 0.05. Results GFAP, NfL 181 lower SCD than patients. In particular, GFAP statistically significant different between ( =0.003), =0.032). vs =0.026), <0.001), FU p=0.033 ), p=0.011 =0.002), =0.003) =0.003). concentration significantly =0.001), =0.020). APOE ϵ4 carriers, increase p<0.001 ) found p=0.014). Moreover, an association emerged age disease onset (p = 0.021) pTau181 0.001) levels. Discussion conclusions promising diagnosis prodromic stages prognosis dementia.

Language: Английский

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Urine biomarkers for Alzheimer's disease: A new opportunity for wastewater-based epidemiology?

Environment International, Journal Year: 2024, Volume and Issue: 184, P. 108462 - 108462

Published: Jan. 28, 2024

While Alzheimer's disease (AD) diagnosis, management, and care have become priorities for healthcare providers researcher's worldwide due to rapid population aging, epidemiologic surveillance efforts are currently limited by costly, invasive diagnostic procedures, particularly in low middle income countries (LMIC). In recent years, wastewater-based epidemiology (WBE) has emerged as a promising tool public health assessment through detection quantification of specific biomarkers wastewater, but applications non-infectious diseases such AD remain limited. This early review seeks summarize AD-related urine other peripheral biofluids discuss their potential integration WBE platforms guide the first prospective field. Promising results been reported clinical settings, indicating amyloid β, tau, neural thread protein, long non-coding RNAs, oxidative stress markers dysregulated metabolites questions regarding concentration stability wastewater correlation between levels sewage circulation must be addressed future studies before comprehensive systems can developed.

Language: Английский

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Medicare spending associated with a dementia diagnosis among older adults

Journal of the American Geriatrics Society, Journal Year: 2022, Volume and Issue: 70(9), P. 2592 - 2601

Published: May 18, 2022

Abstract Background Over 6 million Americans have Alzheimer's Disease or Related Dementia (ADRD) but whether spikes in spending surrounding a new diagnosis reflect pre‐diagnosis morbidity, diagnostic testing, treatments for comorbidities is unknown. Methods We used the 1998–2018 Health and Retirement Study linked Medicare claims from older (≥65) adults to assess incremental quarterly changes just before versus after clinical (diagnosis cohort, n = 2779) and, comparative purposes, cohort screened as impaired based on validated Telephone Interview Cognitive Status (TICS) (impairment 2318). Models were adjusted sociodemographic health characteristics. Spending patterns examined separately by sex, race, education, dual eligibility, geography. Results Among mean (SD) overall was $4773 ($9774) per quarter – 43% of which hospital care ($2048). In analyses, increased $8400 ( p < 0.001), 156%, $5394 prior $13,794 including diagnosis. impairment incidentally detected using TICS, did not change detection impairment, $2986 $2962 0.90). Incremental differ Conclusion Large, transient increases accompany an ADRD that may be attributed functional status due dementia. Further study help reveal how treatment associated with dementia, potential implications spending.

Language: Английский

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Time to dementia diagnosis by race: A retrospective cohort study

Journal of the American Geriatrics Society, Journal Year: 2022, Volume and Issue: 70(11), P. 3250 - 3259

Published: Oct. 6, 2022

Abstract Background Non‐Hispanic Black individuals may be less likely to receive a diagnosis of dementia compared non‐Hispanic White individuals. These findings raise important questions regarding which factors explain this observed association and any differences in the time disparities emerge following onset. Methods We conducted retrospective cohort study using survey data from 1995 2016 Health Retirement Study linked with Medicare fee‐for‐service claims. Using Hurd algorithm (a regression‐based approach), we identified onset among older adult respondents (age ≥65 years) Telephone Interview for Cognitive Status proxy respondents. determined date up 3 years list established codes. Cox Proportional Hazards modeling was used examine between an individual's reported race likelihood after accounting sociodemographic characteristics, income, education, functional status, healthcare use. Results 3435 adults who experienced new dementia. Among them, 30.1% received within 36 months In unadjusted analyses, difference cumulative proportion diagnosed by continued increase across onset, p ‐value <0.001. 23.8% versus 31.4% participants were Hazard Ratio = 0.73 (95% CI: 0.61, 0.88). The persisted adjustment status use; however, these had impact on strength than income level education. Conclusion Lower rates persists Further understanding barriers that related social determinants health is needed improve dementia‐related outcomes Americans.

Language: Английский

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Determinants of Plasma Alzheimer’s Disease Biomarker Use by Primary Care Providers and Dementia Specialists

Journal of General Internal Medicine, Journal Year: 2024, Volume and Issue: 39(9), P. 1713 - 1720

Published: Jan. 2, 2024

Language: Английский

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Designing an intervention to improve cognitive evaluations in primary care

Implementation Science Communications, Journal Year: 2025, Volume and Issue: 6(1)

Published: Jan. 16, 2025

Abstract Background Early diagnosis is crucial to the optimal management of patients with cognitive impairment due Alzheimer’s disease (AD) or AD-related dementias. For some patients, early detection enables access disease-modifying therapies. all it allows psychosocial supports. Patients typically first present their concerns about cognition a primary care provider, but in this setting, commonly underdiagnosed. There also high variability how evaluations are performed. We sought understand barriers and facilitators care, map implementation strategies, gain consensus from stakeholders on possible strategies improve dementia care. Methods Semi-structured interviews conducted providers (PCPs). used Consolidated Framework for Implementation Research inform our question guide analysis, incorporated chart-stimulated recall – using actual who had complaints presented these clinicians’ medical decision-making processes. These data were identified targeted strategies. Then, candidate list was an expert stakeholder panel including clinicians clinical operations specialists. Through modified Delphi process, narrowed select most promising incorporate intervention Results Twenty PCPs interviewed mentioned included lack expertise perform interpret assessment, time pressures, incentives, competing priorities, supports, limited Facilitators presence informant caregiver having additional staff conduct testing. mapping resulted 15 Using six. Conclusions rigorous process identify assessments address barriers, obtain feedback front-line users This holds substantial promise improving future trials.

Language: Английский

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Association of Dementia Severity at Diagnosis with Health Care Utilization and Costs around the Time of Incident Diagnosis

Innovation in Aging, Journal Year: 2025, Volume and Issue: 9(3)

Published: Jan. 1, 2025

Abstract Background and Objectives This study provides the first analysis of heterogeneity in health care use costs by level dementia symptom severity around time incident diagnosis for a population-representative sample older Americans. Research Design Methods We used Aging, Demographics, Memory Study (ADAMS), Health Retirement (HRS), traditional Medicare (TM) claims. modeled measured Clinical Dementia Rating scale ADAMS respondents applied parameter estimates to HRS than 70 years who had claims-based 2000–2016. measures quantified levels quarters before, at, after diagnosis. reported separate results groups persons diagnosed at mild, moderate, severe stages dementia. Results increased quarter before most significantly Both declined thereafter but remained elevated relative prediagnosis. general pattern was consistent different Acute were similar across categories throughout period, whereas outpatient consistently higher among mild stage disease. Discussion Implications Findings from this provide new insights on how is associated with costs. Under current system TM, early may not substantially reduce spending

Language: Английский

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Accountable care organizations and Medicare payments for residents with ADRD in disadvantaged neighborhoods

Alzheimer s & Dementia, Journal Year: 2025, Volume and Issue: 21(3)

Published: March 1, 2025

Abstract INTRODUCTION Accountable care organizations (ACOs) are well positioned to promote coordination. However, robust evidence of ACOs’ impact on Medicare payments for residents with Alzheimer's disease and related dementias (ADRD) in disadvantaged neighborhoods remains limited. METHODS Using a 2016 2020 longitudinal dataset, we examined the effects ACO enrollment people newly diagnosed ADRD, focusing neighborhood Social Vulnerability Index (SVI) its subcategories. Multivariable generalized estimating equation (GEE) models were applied. RESULTS was associated significantly reduced total across all SVI The highest cost savings observed among ADRD patients living high proportions racial ethnic minorities. Results also showed that higher quality ACOs lower payments. DISCUSSION have great potential save health‐care costs beneficiaries socially vulnerable neighborhoods, particularly those residing areas minority populations. Highlights disadvantage levels. reductions varied by specific indicators social vulnerability. Highest found proportion racial/ethnic Cost greatest ACOs.

Language: Английский

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Assessment of Cognitive Impairment and Related Factors Among Elderly People in Jordan

Iranian Journal of Nursing and Midwifery Research, Journal Year: 2024, Volume and Issue: 29(1), P. 120 - 124

Published: Jan. 1, 2024

With an increase in elderly people, it is essential to address the issue of cognitive impairment and support healthy aging. This study aimed assess factors associated with among older adults.

Language: Английский

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