Dataset Information

Does a Cancer Diagnosis in Mid-to-Later Life Modify Racial Disparities in Memory Aging?

ABSTRACT:

Background

It is unknown whether an incident cancer diagnosis differentially impacts acute and long-term memory aging between older White and Black Americans.

Methods

Incident cancer diagnoses and memory (immediate and delayed recall, combined with proxy-reported memory) were assessed at biennial study interviews in the US Health and Retirement Study (N=14,235, 1998-2016). We used multivariable segmented linear mixed-effects models to evaluate the rate of change in standardized memory score (SD/decade) in the years before, acutely at the time of, and in the years following an incident cancer diagnosis, compared to cancer-free adults, by race.

Results

Black participants experienced faster memory decline than White participants (cancer-free group: -1.211 vs. -1.077; P<0.0001). An incident cancer diagnosis was associated with an acute memory drop in White, but not Black participants (-0.065 vs. 0.024; P<0.0001). However, White cancer survivors experienced slower memory decline than cancer-free White adults before and after diagnosis, but this memory advantage was not observed among Black cancer survivors.

Conclusions

Racial disparities in memory aging are not modified by an incident cancer diagnosis. The acute cancer-related memory decline and long-term memory advantage experienced by White, but not Black, cancer survivors relative to cancer-free older adults, requires further investigation.

SUBMITTER: Eastman MR

PROVIDER: S-EPMC9132235 | biostudies-literature | 2022 Apr-Jun 01

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Does a Cancer Diagnosis in Mid-to-Later Life Modify Racial Disparities in Memory Aging?

Eastman Marisa R MR Ospina-Romero Monica M Westrick Ashly C AC Kler Jasdeep S JS Glymour Medellena Maria MM Abdiwahab Ekland E Kobayashi Lindsay C LC

Alzheimer disease and associated disorders 20220204 2

<h4>Background</h4>It is unknown whether an incident cancer diagnosis differentially impacts acute and long-term memory aging between older White and Black Americans.<h4>Methods</h4>Incident cancer diagnoses and memory (immediate and delayed recall, combined with proxy-reported memory) were assessed at biennial study interviews in the US Health and Retirement Study (N=14,235, 1998-2016). We used multivariable segmented linear mixed-effects models to evaluate the rate of change in standardized me ...[more]

PMID: 35125398

Similar Datasets

Project description:BackgroundThe quality of end-of-life (EOL) care in the USA remains suboptimal, with significant variations in care by race and across disease subgroups. Patient-provider communication may contribute to racial and disease-specific variations in EOL care outcomes.ObjectiveWe examined racial disparities in EOL care, by disease group (cancer vs. non-cancer), and assessed whether racial differences in patient-provider communication accounted for observed disparities.DesignRetrospective cohort study using the 2001-2015 Surveillance, Epidemiology, and End Results - Consumer Assessment of Healthcare Providers and Systems data linked with Medicare claims (SEER-CAHPS). We employed stratified propensity score matching and modified Poisson regression analyses, adjusting for clinical and demographic characteristics PARTICIPANTS: Black and White Medicare beneficiaries 65 years or older with cancer (N=2000) or without cancer (N=11,524).Main measuresEnd-of-life care measures included hospice use, inpatient hospitalizations, intensive care unit (ICU) stays, and emergency department (ED) visits, during the 90 days prior to death.Key resultsWhen considering all conditions together (cancer + non-cancer), Black beneficiaries were 26% less likely than their Whites counterparts to enroll in hospice (adjusted risk ratio [ARR]: 0.74, 95%CI: 0.66-0.83). Among beneficiaries without cancer, Black beneficiaries had a 32% lower likelihood of enrolling in hospice (ARR: 0.68, 95%CI: 0.59-0.79). There was no racial difference in hospice enrollment among cancer patients. Black beneficiaries were also at increased risk for ED use (ARR: 1.12, 95%CI: 1.01-1.26). Patient-provider communication did not explain racial disparities in hospice or ED use. There were no racial differences in hospitalizations or ICU admissions.ConclusionWe observed racial disparities in hospice use and ED visits in the 90 days prior to death among Medicare beneficiaries; however, hospice disparities were largely driven by patients without cancer. Condition-specific differences in palliative care integration at the end-of-life may partly account for variations in EOL care disparities across disease groups.

Dataset Information

Does a Cancer Diagnosis in Mid-to-Later Life Modify Racial Disparities in Memory Aging?

Background

Methods

Results

Conclusions

Publications

Does a Cancer Diagnosis in Mid-to-Later Life Modify Racial Disparities in Memory Aging?

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets