Co-occurring conditions and racial-ethnic disparities: Medicaid enrolled adults on the autism spectrum / W. SCHOTT in Autism Research, 15-1 (January 2022)  

Public ISBD [article]  inAutism Research > 15-1 (January 2022) . - p.70-85 Titre : Co-occurring conditions and racial-ethnic disparities: Medicaid enrolled adults on the autism spectrum Type de document : Texte imprimé et/ou numérique Auteurs : W. SCHOTT, Auteur ; S. TAO, Auteur ; L. SHEA, Auteur Article en page(s) : p.70-85 Langues : Anglais (eng) Mots-clés : Adult  Autism Spectrum Disorder/epidemiology  Autistic Disorder  Ethnicity  Humans  Medicaid  Minority Groups  United States/epidemiology  adults  autism  co-occurring conditions  racial disparities Index. décimale : PER Périodiques Résumé : Evidence suggests that autistic adults have higher odds of developing several co-occurring conditions, but less is known about disparities by race and ethnicity in this population. Using 2008-2012 Medicaid Analytic eXtract (MAX) data, we (i) identify the prevalence of co-occurring conditions among the population of autistic adult Medicaid beneficiaries compared to a matched sample of those without an autism spectrum disorder (ASD) diagnosis, (ii) conduct logistic regression to estimate odds ratios for these health conditions predicted by an autism diagnosis, and (iii) estimate odds of having these health conditions as predicted by racial/ethnic group among the autistic population only. Overall, autistic adults did not have higher prevalence of some major health conditions (cardiovascular conditions, stroke, cancer, cardiovascular disease), but they did have higher odds of others (nutrition conditions, epilepsy, disorders of the central nervous system). Analysis by racial/ethnic group, however, shows that Black, Hispanic, and Asian autistic beneficiaries had higher odds of diabetes, hospitalized cardiovascular diseases, and hypertension, among other conditions. Policymakers should be aware that racial disparities found in the general population persist in the autistic population and should work to implement systems and programs to improve screening and preventive care for minority autistic populations. LAY SUMMARY: Autistic adults may have several co-occurring physical and mental health conditions, which could differ by racial/ethnic group. We find that, compared to the general Medicaid population, autistic adult Medicaid beneficiaries have elevated odds of some health conditions, like epilepsy and nutrition conditions, as well as some psychiatric conditions, such as anxiety and attention disorders. We also find that many of the same health disparities by racial/ethnic group in the general population persist among the autistic adult Medicaid population. For example, Black, Hispanic, and Asian Medicaid autistic beneficiaries have higher odds of diabetes, and Black and Hispanic autistic beneficiaries have higher odds of obesity and nutrition conditions than white autistic beneficiaries. En ligne : http://dx.doi.org/10.1002/aur.2644 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=450 [article] Co-occurring conditions and racial-ethnic disparities: Medicaid enrolled adults on the autism spectrum [Texte imprimé et/ou numérique] / W. SCHOTT, Auteur ; S. TAO, Auteur ; L. SHEA, Auteur . - p.70-85. Langues : Anglais (eng) in Autism Research > 15-1 (January 2022) . - p.70-85 Mots-clés : Adult  Autism Spectrum Disorder/epidemiology  Autistic Disorder  Ethnicity  Humans  Medicaid  Minority Groups  United States/epidemiology  adults  autism  co-occurring conditions  racial disparities Index. décimale : PER Périodiques Résumé : Evidence suggests that autistic adults have higher odds of developing several co-occurring conditions, but less is known about disparities by race and ethnicity in this population. Using 2008-2012 Medicaid Analytic eXtract (MAX) data, we (i) identify the prevalence of co-occurring conditions among the population of autistic adult Medicaid beneficiaries compared to a matched sample of those without an autism spectrum disorder (ASD) diagnosis, (ii) conduct logistic regression to estimate odds ratios for these health conditions predicted by an autism diagnosis, and (iii) estimate odds of having these health conditions as predicted by racial/ethnic group among the autistic population only. Overall, autistic adults did not have higher prevalence of some major health conditions (cardiovascular conditions, stroke, cancer, cardiovascular disease), but they did have higher odds of others (nutrition conditions, epilepsy, disorders of the central nervous system). Analysis by racial/ethnic group, however, shows that Black, Hispanic, and Asian autistic beneficiaries had higher odds of diabetes, hospitalized cardiovascular diseases, and hypertension, among other conditions. Policymakers should be aware that racial disparities found in the general population persist in the autistic population and should work to implement systems and programs to improve screening and preventive care for minority autistic populations. LAY SUMMARY: Autistic adults may have several co-occurring physical and mental health conditions, which could differ by racial/ethnic group. We find that, compared to the general Medicaid population, autistic adult Medicaid beneficiaries have elevated odds of some health conditions, like epilepsy and nutrition conditions, as well as some psychiatric conditions, such as anxiety and attention disorders. We also find that many of the same health disparities by racial/ethnic group in the general population persist among the autistic adult Medicaid population. For example, Black, Hispanic, and Asian Medicaid autistic beneficiaries have higher odds of diabetes, and Black and Hispanic autistic beneficiaries have higher odds of obesity and nutrition conditions than white autistic beneficiaries. En ligne : http://dx.doi.org/10.1002/aur.2644 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=450

The prevalence and incidence of early-onset dementia among adults with autism spectrum disorder / G. VIVANTI in Autism Research, 14-10 (October 2021)  

Public ISBD [article]  inAutism Research > 14-10 (October 2021) . - p.2189-2199 Titre : The prevalence and incidence of early-onset dementia among adults with autism spectrum disorder Type de document : Texte imprimé et/ou numérique Auteurs : G. VIVANTI, Auteur ; S. TAO, Auteur ; K. LYALL, Auteur ; Diana L. ROBINS, Auteur ; L. L. SHEA, Auteur Article en page(s) : p.2189-2199 Langues : Anglais (eng) Mots-clés : Adult  Autism Spectrum Disorder/complications/epidemiology  Case-Control Studies  Dementia/epidemiology  Humans  Incidence  Intellectual Disability/epidemiology  Middle Aged  Prevalence  United States/epidemiology Index. décimale : PER Périodiques Résumé : The prevalence and incidence of early-onset dementia among adults with autism spectrum disorder (ASD) is currently unknown. In this case-control study, the prevalence and incidence of early-onset dementia in individuals with ASD was examined during 2008-2012 using Medicaid Analytic eXtract files. Participants were 30-64?year-old adults who were Medicaid beneficiaries and had either a diagnosis of ASD only (n = 12,648), a diagnosis of ASD with co-occurring intellectual disability (ID) (n = 26,168), a diagnosis of ID without ASD (n = 406,570), or no ASD nor ID diagnoses (n = 798,828). The 5-year prevalence of dementia was 4.04% among adults with ASD only, and 5.22% for those with ASD and co-occurring ID. This prevalence was higher compared to the prevalence of dementia in individuals with no ASD and no ID (0.97%), but lower compared to individuals with ID only (7.10%). Risk factors associated with the increased prevalence in the general population were similarly associated with the increased risk of dementia in individuals with ASD. Even after adjusting for these risk factors, compared to the general population, dementia was found to occur more frequently in individuals with ASD only (adjusted hazard ratio, 1.96; 95% CI, 1.69-2.28), as well as individuals with ASD and co-occurring ID (adjusted hazard ratio, 2.89; 95% CI, 2.62-3.17). In conclusion, adults with ASD under the age of 65 were approximately 2.6 times more likely to be diagnosed with dementia compared to the general population in our study. LAY SUMMARY: It is unclear whether adults diagnosed with autism spectrum disorder (ASD) are at higher risk of being diagnosed with early-onset dementia compared to those who are not on the autism spectrum. In this study we examined for the first time the nationwide prevalence and incidence of Alzheimer's Disease and other types of dementia in ASD in a sample of adults with ASD aged 30-64?years who were enrolled in Medicaid, the largest insurer of behavioral health services in the US. Medicaid claims data, which include information on the diagnoses that beneficiaries receive, suggested that the adults with ASD were approximately 2.6 times more likely to be diagnosed with early-onset Alzheimer's disease and related dementias compared to the general population. En ligne : http://dx.doi.org/10.1002/aur.2590 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=450 [article] The prevalence and incidence of early-onset dementia among adults with autism spectrum disorder [Texte imprimé et/ou numérique] / G. VIVANTI, Auteur ; S. TAO, Auteur ; K. LYALL, Auteur ; Diana L. ROBINS, Auteur ; L. L. SHEA, Auteur . - p.2189-2199. Langues : Anglais (eng) in Autism Research > 14-10 (October 2021) . - p.2189-2199 Mots-clés : Adult  Autism Spectrum Disorder/complications/epidemiology  Case-Control Studies  Dementia/epidemiology  Humans  Incidence  Intellectual Disability/epidemiology  Middle Aged  Prevalence  United States/epidemiology Index. décimale : PER Périodiques Résumé : The prevalence and incidence of early-onset dementia among adults with autism spectrum disorder (ASD) is currently unknown. In this case-control study, the prevalence and incidence of early-onset dementia in individuals with ASD was examined during 2008-2012 using Medicaid Analytic eXtract files. Participants were 30-64?year-old adults who were Medicaid beneficiaries and had either a diagnosis of ASD only (n = 12,648), a diagnosis of ASD with co-occurring intellectual disability (ID) (n = 26,168), a diagnosis of ID without ASD (n = 406,570), or no ASD nor ID diagnoses (n = 798,828). The 5-year prevalence of dementia was 4.04% among adults with ASD only, and 5.22% for those with ASD and co-occurring ID. This prevalence was higher compared to the prevalence of dementia in individuals with no ASD and no ID (0.97%), but lower compared to individuals with ID only (7.10%). Risk factors associated with the increased prevalence in the general population were similarly associated with the increased risk of dementia in individuals with ASD. Even after adjusting for these risk factors, compared to the general population, dementia was found to occur more frequently in individuals with ASD only (adjusted hazard ratio, 1.96; 95% CI, 1.69-2.28), as well as individuals with ASD and co-occurring ID (adjusted hazard ratio, 2.89; 95% CI, 2.62-3.17). In conclusion, adults with ASD under the age of 65 were approximately 2.6 times more likely to be diagnosed with dementia compared to the general population in our study. LAY SUMMARY: It is unclear whether adults diagnosed with autism spectrum disorder (ASD) are at higher risk of being diagnosed with early-onset dementia compared to those who are not on the autism spectrum. In this study we examined for the first time the nationwide prevalence and incidence of Alzheimer's Disease and other types of dementia in ASD in a sample of adults with ASD aged 30-64?years who were enrolled in Medicaid, the largest insurer of behavioral health services in the US. Medicaid claims data, which include information on the diagnoses that beneficiaries receive, suggested that the adults with ASD were approximately 2.6 times more likely to be diagnosed with early-onset Alzheimer's disease and related dementias compared to the general population. En ligne : http://dx.doi.org/10.1002/aur.2590 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=450

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