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Causal pathway to analyze racial disparities in ADRD
Author(s) -
Kim Yejin,
Jiang Xiaoqian
Publication year - 2020
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.037081
Subject(s) - comorbidity , medicine , dementia , diabetes mellitus , obesity , socioeconomic status , health equity , disease , race (biology) , gerontology , propensity score matching , environmental health , public health , pathology , endocrinology , population , botany , biology
Background Health disparities in prevalence of Alzheimer’s disease and related dementia (ADRD) across different racial groups are mostly due to variations in socioeconomic status and comorbidity such as cardiovascular disease, diabetes, and obesity. We aim to investigate multifactorial influence of comorbidity to the ADRD risk for African Americans compared to Caucasian. Method From 106 million patients’ electronic medical records in Cerner Health Facts, we built paired and comparable cohorts of each racial group by matching age, observation window, cardiovascular diseases, diabetes, obesity, and head injury. We then derived causal graphs respectively using PC algorithms. Result We found that the two causal graphs from African‐American and its paired Caucasian show very different clinical pathway to ADRD, even though the two cohorts follow similar distribution except race. For African‐American, we found three inflammatory pathways and one cardiology pathway, whereas for paired Caucasian, we found a pathway from polyneuropathy to septicemia, and dementia. Conclusion Our study identified the root and pathway of comorbidity risk factors, which hopefully will reveal more information about the differential weights of known risk factors to patients of different race.