INS NYC 2024 Program

Poster	Poster Session 11 Program Schedule 02/17/2024 10:45 am - 12:00 pm Room: Majestic Complex (Posters 61-120) Poster Session 11: Cultural Neuropsychology \| Education/Training \| Professional Practice Issues Final Abstract #79 Ethno-Racial Differences in a Group of Persons with Dementia and Caregivers Enrolled in the Care Ecosystem Program Carolina Pereira, Ochsner Health, New Orleans, United States Bern Lee, Ochsner Health, Baton Rouge, United States Beth Arredondo, Ochsner Health, New Orleans, United States Anneliese Boettcher, Ochsner Health, New Orleans, United States Emily Brickell, Ochsner Health, New Orleans, United States Robert Sawyer, Ochsner Health, New Orleans, United States Category: Dementia (Alzheimer's Disease) Keyword 1: dementia - Alzheimer's disease Keyword 2: diversity Keyword 3: ethnicity Objective: Dementia research is limited in terms of racial diversity. We expanded on prior research that explored sociodemographic, clinical, and healthcare utilization (HCU) data in an ethno-racially diverse sample of persons living with dementia (PWD) and caregivers (CG) in New Orleans, Louisiana, and surrounding areas. This study also aims to better understand the populations being reached by the Care Ecosystem Program (dementia care management program) to consequently improve outreach efforts. Participants and Methods: Baseline data for 196 dyads (PWD-CG) enrolled in the Care Ecosystem from January to August 2023 were analyzed. Participants had at least 1 emergency or hospital admission 12-months prior to enrollment, an established dementia diagnosis, and were aged 55 or older. Data points integrated sociodemographic, dementia ratings (QDRS, NPI), CG wellbeing (GAD2, PHQ9, MCSI) and self-efficacy measures, and HCU extracted from electronic medical records. One-way ANOVAs, Kruskal-Wallis, and Chi-Square were used to compare variables of interest by ethno-racial group: Non-Hispanic White (NHW), Hispanic White (HW), and Black/African American (BAA). Extreme outliers were Winsorized to the 95^th percentile and a p-value of 0.05 determined significance. On average, PWD and CGs were 80 (SD:7) and 61 years-old (SD:12), respectively, and predominantly female (PWD:68%, CG: 77%). CG health literacy was high, with 90% rating their confidence level to fill out medical forms a 4 (‘Quite a bit’) or a 5 (‘Extremely’) on a 5-point Likert Scale. Ethno-racial distribution was similar for PWD (NHW: 97, HW:19, BAA: 80) and CGs (NHW:91, HW:26, BAA: 79). Results: HW-PWD were significantly older [F(2,193)=6.35, p<0.05] and had more advanced dementia [X²(2)=6.42, p=0.04] when compared to NHW-PWD (M ∆: -6.2, 95% CI [-10.5, -1.9]) and BAA-PWD (M ∆: -6.1, 95% CI [-10.4, -1.8]). HW- and BAA-CGs were more likely to be female when compared to their NHW counterparts [X²(2)=8.82, p=0.01]. Similarly, there were significantly more female PWD in the BAA group when compared to the NHW- and HW-PWD groups [X²(2)=9.97, p<0.05]. No other sociodemographic or clinical differences were identified between ethno-racial PWD and CG groups. Baseline Emergency Department utilization was higher for NHW-PWD [F(2, 65.6)=4.29, p=0.02] when compared to HW-PWD (M ∆: -0.79, 95% CI [0.14, -1.44]). No other differences were found in HCU between ethno-racial groups. Conclusions: Sociodemographic, clinical, and HCU differences were found across ethno-racial PWD and CG groups. Minority caregivers were more likely to be female, and Black PWD were more likely to be female. HW-PWD were found to have reduced Emergency Department utilization despite having an older patient population with more advanced dementia, possibly reflecting systemic barriers to care. Reasons for sociodemographic, clinical, and HCU differences will be discussed with an emphasis on healthcare access, healthcare resources, and cultural factors that may explain our findings More research is needed to reduce barriers to care and identify points of intervention tailored to the needs of each ethno-racial group. Self-reported measures and non-parametric analyses due to small group sample sizes may limit the generalizability of our findings.

Poster

02/17/2024
10:45 am - 12:00 pm
Room: Majestic Complex (Posters 61-120)

Poster Session 11: Cultural Neuropsychology | Education/Training | Professional Practice Issues

Final Abstract #79

Ethno-Racial Differences in a Group of Persons with Dementia and Caregivers Enrolled in the Care Ecosystem Program

Carolina Pereira, Ochsner Health, New Orleans, United States
Bern Lee, Ochsner Health, Baton Rouge, United States
Beth Arredondo, Ochsner Health, New Orleans, United States
Anneliese Boettcher, Ochsner Health, New Orleans, United States
Emily Brickell, Ochsner Health, New Orleans, United States
Robert Sawyer, Ochsner Health, New Orleans, United States

Category: Dementia (Alzheimer's Disease)

Keyword 1: dementia - Alzheimer's disease
Keyword 2: diversity
Keyword 3: ethnicity

Objective:

Dementia research is limited in terms of racial diversity. We expanded on prior research that explored sociodemographic, clinical, and healthcare utilization (HCU) data in an ethno-racially diverse sample of persons living with dementia (PWD) and caregivers (CG) in New Orleans, Louisiana, and surrounding areas. This study also aims to better understand the populations being reached by the Care Ecosystem Program (dementia care management program) to consequently improve outreach efforts.

Participants and Methods:

Baseline data for 196 dyads (PWD-CG) enrolled in the Care Ecosystem from January to August 2023 were analyzed. Participants had at least 1 emergency or hospital admission 12-months prior to enrollment, an established dementia diagnosis, and were aged 55 or older. Data points integrated sociodemographic, dementia ratings (QDRS, NPI), CG wellbeing (GAD2, PHQ9, MCSI) and self-efficacy measures, and HCU extracted from electronic medical records. One-way ANOVAs, Kruskal-Wallis, and Chi-Square were used to compare variables of interest by ethno-racial group: Non-Hispanic White (NHW), Hispanic White (HW), and Black/African American (BAA). Extreme outliers were Winsorized to the 95^th percentile and a p-value of 0.05 determined significance. On average, PWD and CGs were 80 (SD:7) and 61 years-old (SD:12), respectively, and predominantly female (PWD:68%, CG: 77%). CG health literacy was high, with 90% rating their confidence level to fill out medical forms a 4 (‘Quite a bit’) or a 5 (‘Extremely’) on a 5-point Likert Scale. Ethno-racial distribution was similar for PWD (NHW: 97, HW:19, BAA: 80) and CGs (NHW:91, HW:26, BAA: 79).

Results:

HW-PWD were significantly older [F(2,193)=6.35, p<0.05] and had more advanced dementia [X²(2)=6.42, p=0.04] when compared to NHW-PWD (M ∆: -6.2, 95% CI [-10.5, -1.9]) and BAA-PWD (M ∆: -6.1, 95% CI [-10.4, -1.8]). HW- and BAA-CGs were more likely to be female when compared to their NHW counterparts [X²(2)=8.82, p=0.01]. Similarly, there were significantly more female PWD in the BAA group when compared to the NHW- and HW-PWD groups [X²(2)=9.97, p<0.05]. No other sociodemographic or clinical differences were identified between ethno-racial PWD and CG groups. Baseline Emergency Department utilization was higher for NHW-PWD [F(2, 65.6)=4.29, p=0.02] when compared to HW-PWD (M ∆: -0.79, 95% CI [0.14, -1.44]). No other differences were found in HCU between ethno-racial groups.

Conclusions:

Sociodemographic, clinical, and HCU differences were found across ethno-racial PWD and CG groups. Minority caregivers were more likely to be female, and Black PWD were more likely to be female. HW-PWD were found to have reduced Emergency Department utilization despite having an older patient population with more advanced dementia, possibly reflecting systemic barriers to care. Reasons for sociodemographic, clinical, and HCU differences will be discussed with an emphasis on healthcare access, healthcare resources, and cultural factors that may explain our findings More research is needed to reduce barriers to care and identify points of intervention tailored to the needs of each ethno-racial group. Self-reported measures and non-parametric analyses due to small group sample sizes may limit the generalizability of our findings.