I see nothing here that even suggests that they have any clue how to address this problem. Probably because they are
http://dgnews.docguide.com/post-stroke-cognitive-outcomes-worse-mexican-americans?
By Brian Hoyle
SAN DIEGO, California -- October 18, 2017 -- Cognitive outcomes following stroke are markedly worse for Mexican Americans than for non-Hispanic whites, according to results of a population-based study presented at the 142nd Annual Meeting of the American Neurological Association (ANA).
“This…study found a highly significant, worse cognitive outcome…even after adjusting for age, sex, pre-stroke cognition, insurance status, comorbidities and initial stroke severity,” stated lead author Lewis Morgenstern, MD, University of Michigan School of Public Health, Ann Arbor, Michigan, at a poster presentation here on October 15.
Dr. Morgenstern and colleagues used data assembled between October 2014 and January 2016 for 576 patients participating in the Brain Attack Surveillance in Corpus Christi (BASIC) project. Using the Modified Mini-Mental State Examination (MMSE), the BASIC project assessed cognitive outcome at 3, 6, and 12 months following stroke for both Mexican American and non-Hispanic subjects. Three, 6, and 12-month follow-up data were available for 315, 244, and 227 subjects, respectively.
The researchers determined differences in cognitive outcome based on ethnicity using a model that adjusted for age and sex (model 1), responses to the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) (model 2), insurance status (model 3), diabetes and comorbidities (model 4), and initial scores from the National Institutes of Health Stroke Scale (NIHSS) (model 5).
At 12 months, the cognitive outcome was worse for Mexican Americans than it was for non-Hispanic subjects (median MMSE score 86 [interquartile range: 73 to 93] vs 92 [interquartile range: 83 to 96]).
Mexican Americans scored significantly worse than non-Hispanics on the MMSE (5.56, 95% confidence interval [CI] 2.67 to 8.44; P < .001) in unadjusted analyses. This disparity increased when the data were adjusted using model 1 (6.88, 95% CI: 4.15 to 9.60), model 2 (7.04, 95% CI: 4.09 to 9.99), model 3 (7.04, 95% CI: 4.06 to 10.02), model 4 (7.11, 95% CI: 4.10 to 10.11), and model 5 (6.73, 95% CI: 3.88 to 9.57).
Both groups were similar at baseline in terms of sex, smoking, alcohol consumption, prevalence of hypertension, prevalence of heart disease, history of stroke, cholesterol level, NIHSS score, comorbidities, IQCODE responses, and insurance coverage. Mexican Americans, however, differed significantly from non-Hispanics in terms of age (median 66 vs 70 years; P = .018), prevalence of diabetes (54% vs 36%; P < .001), and prevalence of atrial fibrillation (13% vs 20%; P = .025).
The BASIC stroke surveillance project began in 1999, and is ongoing. It is unique in its focus on Mexican Americans, the largest segment of the Hispanic population in the U.S., and the country’s largest minority population overall. The BASIC cohort comprises approximately 5,000 patients with cerebrovascular disease; all have been followed to gauge the recurrence of cerebrovascular events and death.
The incidence and recurrence of stroke are known to be higher in Mexican Americans compared with non-Hispanics, as are the consequences of stroke in terms of functional and neurologic outcomes. Information on why Mexican Americans are disproportionally vulnerable to worse stroke outcomes is required if this situation is to be alleviated, the researchers concluded.
Funding was provided by the Department of Health and Human Services, National Institutes of Health, Bethesda, Maryland.
[Presentation title: The Large Disparity in Cognitive Outcomes After Stroke in Mexican Americans and Non Hispanic Whites. Abstract S144]
WAITING FOR SOMEONE ELSE TO SOLVE THE PROBLEM?
http://dgnews.docguide.com/post-stroke-cognitive-outcomes-worse-mexican-americans?
By Brian Hoyle
SAN DIEGO, California -- October 18, 2017 -- Cognitive outcomes following stroke are markedly worse for Mexican Americans than for non-Hispanic whites, according to results of a population-based study presented at the 142nd Annual Meeting of the American Neurological Association (ANA).
“This…study found a highly significant, worse cognitive outcome…even after adjusting for age, sex, pre-stroke cognition, insurance status, comorbidities and initial stroke severity,” stated lead author Lewis Morgenstern, MD, University of Michigan School of Public Health, Ann Arbor, Michigan, at a poster presentation here on October 15.
Dr. Morgenstern and colleagues used data assembled between October 2014 and January 2016 for 576 patients participating in the Brain Attack Surveillance in Corpus Christi (BASIC) project. Using the Modified Mini-Mental State Examination (MMSE), the BASIC project assessed cognitive outcome at 3, 6, and 12 months following stroke for both Mexican American and non-Hispanic subjects. Three, 6, and 12-month follow-up data were available for 315, 244, and 227 subjects, respectively.
The researchers determined differences in cognitive outcome based on ethnicity using a model that adjusted for age and sex (model 1), responses to the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) (model 2), insurance status (model 3), diabetes and comorbidities (model 4), and initial scores from the National Institutes of Health Stroke Scale (NIHSS) (model 5).
At 12 months, the cognitive outcome was worse for Mexican Americans than it was for non-Hispanic subjects (median MMSE score 86 [interquartile range: 73 to 93] vs 92 [interquartile range: 83 to 96]).
Mexican Americans scored significantly worse than non-Hispanics on the MMSE (5.56, 95% confidence interval [CI] 2.67 to 8.44; P < .001) in unadjusted analyses. This disparity increased when the data were adjusted using model 1 (6.88, 95% CI: 4.15 to 9.60), model 2 (7.04, 95% CI: 4.09 to 9.99), model 3 (7.04, 95% CI: 4.06 to 10.02), model 4 (7.11, 95% CI: 4.10 to 10.11), and model 5 (6.73, 95% CI: 3.88 to 9.57).
Both groups were similar at baseline in terms of sex, smoking, alcohol consumption, prevalence of hypertension, prevalence of heart disease, history of stroke, cholesterol level, NIHSS score, comorbidities, IQCODE responses, and insurance coverage. Mexican Americans, however, differed significantly from non-Hispanics in terms of age (median 66 vs 70 years; P = .018), prevalence of diabetes (54% vs 36%; P < .001), and prevalence of atrial fibrillation (13% vs 20%; P = .025).
The BASIC stroke surveillance project began in 1999, and is ongoing. It is unique in its focus on Mexican Americans, the largest segment of the Hispanic population in the U.S., and the country’s largest minority population overall. The BASIC cohort comprises approximately 5,000 patients with cerebrovascular disease; all have been followed to gauge the recurrence of cerebrovascular events and death.
The incidence and recurrence of stroke are known to be higher in Mexican Americans compared with non-Hispanics, as are the consequences of stroke in terms of functional and neurologic outcomes. Information on why Mexican Americans are disproportionally vulnerable to worse stroke outcomes is required if this situation is to be alleviated, the researchers concluded.
Funding was provided by the Department of Health and Human Services, National Institutes of Health, Bethesda, Maryland.
[Presentation title: The Large Disparity in Cognitive Outcomes After Stroke in Mexican Americans and Non Hispanic Whites. Abstract S144]
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