title: Inequalities in dementia incidence between six racial and ethnic groups over 14 years.
abstract: BACKGROUND
  Reducing racial/ethnic disparities is a primary objective of the National Alzheimer's Plan (NAPA), yet direct comparisons within large samples representing diversity of the United States are lacking.
  
  
  METHODS
  Dementia incidence from January 1, 2000 to December 31, 2013 and a 25-year cumulative risk in 274,283 health care members aged 64+ (n = 18,778 African-American, n = 4543 American Indian/Alaska Native [AIAN], n = 21,000 Latino, n = 440 Pacific Islander, n = 206,490 white, n = 23,032 Asian-Americans). Cox proportional hazard models were adjusted for age, sex, medical utilization, and comorbidities.
  
  
  RESULTS
  Dementia incidence (n = 59,555) was highest for African-Americans (26.6/1000 person-years) and AIANs (22.2/1000 person-years); intermediate for Latinos (19.6/1000 person-years), Pacific Islanders (19.6/1000 person-years), and whites (19.3/1000 person-years) and lowest among Asian-Americans (15.2/1000 person-years). Risk was 65% greater for African-Americans (hazard ratio = 1.65; 95% confidence interval = 1.58-1.72) versus Asian-Americans. Cumulative 25-year risk at age 65 was as follows: 38% African-Americans, 35% AIANs, 32% Latino, 25% Pacific Islanders, 30% white, and 28% Asian-Americans.
  
  
  CONCLUSIONS
  Dementia rates varied over 60% between groups, providing a comprehensive benchmark for the NAPA goal of reducing disparities.
authors.affiliation: Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA.
authors.forename: Elizabeth Rose
authors.initials: ER
authors.lastname: Mayeda
authors.affiliation: Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA.
authors.forename: M Maria
authors.initials: MM
authors.lastname: Glymour
authors.affiliation: Kaiser Permanente Division of Research, Oakland, CA, USA.
authors.forename: Charles P
authors.initials: CP
authors.lastname: Quesenberry
authors.affiliation: Kaiser Permanente Division of Research, Oakland, CA, USA; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA. Electronic address: Rachel.Whitmer@kp.org.
authors.forename: Rachel A
authors.initials: RA
authors.lastname: Whitmer
mesh_terms: D001741:Black or African American; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003695:Delivery of Health Care / Q000706:statistics & numerical data; D003704:Dementia / Q000453:epidemiology* / Q000208:ethnology*; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D015994:Incidence; D007198:Indians, North American; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012737:Sex Factors; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D044465:White People
keywords: Cohort; Dementia; Disparities; Epidemiology; Ethnicity; Race