Background: Ethnic disparities in patterns of utilization and outcomes after Roux-en-Y gastric bypass surgery (RYGB) were examined from Bariatric Outcomes Longitudinal Database.
Methods: Descriptive statistics were used for demographics of Whites, Blacks, or Hispanics undergoing RYGB with 1 year of follow-up, between June 2007 and October 2011. Multivariate logistic and normal regression models, controlling for baseline characteristics, examined relationships between race and outcomes. T tests were used for continuous variables and Pearson chi-square test for categorical variables.
Results: Study patients (108,333) were79 % White, 12 % Black, and 9 % Hispanic. Fewer Black males underwent surgery (15 %) compared to Whites or Hispanics (∼22 %). Blacks compared to Whites were younger (42.7 ± 10.6 vs. 46.4 ± 11.6 years), heavier BMI (50 ± 9.1 vs. 47.4 ± 8.0 kg/m(2)), and more often hypertensive (57 vs. 52 %). Other comorbidities were higher in Whites. Thirty-day mortality rate was equivalent (0.23-0.26 %), but serious adverse events were higher for Blacks (3.65 %) versus Whites (3.19 %) and Hispanics (2.01 %). At 1 year, weight and comorbidity burden declined significantly but less in Blacks despite adjustment for baseline characteristics.
Conclusions: Fewer Black males underwent RYGB. Despite a smaller percent decline in BMI and comorbidities in Blacks, all races benefitted significantly from RYGB. Influence of other factors such as diet, culture, and genetics needs to be investigated further.
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http://dx.doi.org/10.1007/s11605-013-2368-1 | DOI Listing |
Background: Dementia is underdiagnosed by the healthcare system, and MCI is rarely identified. Thus, while interventions to reduce cognitive decline are becoming increasingly available, it is not clear how appropriate individuals will be evaluated for treatment opportunities. A first step to improving diagnosis is understanding how older individuals with dementia or MCI interact with the healthcare system, especially ambulatory evaluation and management (E&M) visits, the backbone of healthcare.
View Article and Find Full Text PDFBackground: Midlife cardiovascular risk factors (CVRF) are associated with late-life cognitive impairment, but also mortality. We evaluated their association with cognitive decline in a diverse cohort of older adults who survived to age 80 without diagnosis of dementia.
Method: Three harmonized cohorts of long-term Kaiser Permanente members were pooled and restricted to those aged 80+.
Alzheimers Dement
December 2024
San Francisco State University, San Francisco, CA, USA.
Background: Higher school quality, and decreased student-teacher ratio in particular, is associated with improvements in late-life cognition. New deal emergency employment programs in the 1930s provided funding for hundreds of thousands of teachers in response to sweeping school budget cuts of the Great Depression. We examine the association between increased area-level teacher employment through the Public Emergency Work (PEW) programs and late-life cognition.
View Article and Find Full Text PDFBackground: Previous research suggests dementia is undetected in healthcare settings for more than half of those with dementia. Most research on underdiagnosis of dementia has focused on the presence or absence of a clinical diagnosis in claims or the medical record without addressing differences in the timeliness of a diagnosis. Little is known about factors that may be related to the timeliness of clinical dementia diagnosis.
View Article and Find Full Text PDFJ Telemed Telecare
January 2025
Mental Health Service, San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA.
Introduction: Trauma-focused evidence-based psychotherapy (EBP) is the recommended treatment for post-traumatic stress disorder (PTSD). During and after the COVID-19 pandemic, veterans began to initiate general mental health services delivered via video telehealth at high rates. Our goal in the current project was to describe the percentage as well as the demographic, military, and clinical characteristics of veterans receiving PTSD EBPs via video telehealth versus in-person.
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