Propensity Scores in Health Disparities Research: The Example of Cognitive Aging and the Hispanic Paradox

被引:2
作者
Kezios, Katrina L. [1 ,4 ]
Zimmerman, Scott C. [2 ]
Zhang, Adina [1 ]
Calonico, Sebastian [3 ]
Jawadekar, Neal [1 ]
Glymour, M. Maria [2 ]
Zeki Al Hazzouri, Adina [1 ]
机构
[1] Columbia Univ, Mailman Sch Publ Hlth, Dept Epidemiol, New York, NY USA
[2] Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA USA
[3] Columbia Univ, Mailman Sch Publ Hlth, Dept Hlth Policy & Management, New York, NY USA
[4] Columbia Univ, Mailman Sch Publ Hlth, Dept Epidemiol, Room 504, 722 W 168th St, New York, NY 10032 USA
基金
美国国家卫生研究院;
关键词
Cognitive aging; Hispanic paradox; Memory; Propensity score; Social determinants; INTERNATIONAL MIGRATION; MEXICAN IMMIGRANTS; STRUCTURAL RACISM; UNITED-STATES; US MIGRATION; RISK-FACTORS; EARLY-LIFE; SELECTION; POSITIVITY; MIGRANTS;
D O I
10.1097/EDE.0000000000001620
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background:Individuals of Mexican ancestry in the United States experience substantial socioeconomic disadvantages compared with non-Hispanic white individuals; however, some studies show these groups have similar dementia risk. Evaluating whether migration selection factors (e.g., education) associated with risk of Alzheimer disease and related dementia (ADRD) explain this paradoxical finding presents statistical challenges. Intercorrelation of risk factors, common with social determinants, could make certain covariate patterns very likely or unlikely to occur for particular groups, which complicates their comparison. Propensity score (PS) methods could be leveraged here to diagnose nonoverlap and help balance exposure groups. Methods:We compare conventional and PS-based methods to examine differences in cognitive trajectories between foreign-born Mexican American, US-born Mexican American, and US-born non-Hispanic white individuals in the Health and Retirement Study (1994-2018). We examined cognition using a global measure. We estimated trajectories of cognitive decline from linear mixed models adjusted for migration selection factors also associated with ADRD risk conventionally or with inverse probability weighting. We also employed PS trimming and match weighting. Results:In the full sample, where PS overlap was poor, unadjusted analyses showed both Mexican ancestry groups had worse baseline cognitive scores but similar or slower rates of decline compared with non-Hispanic white adults; adjusted findings were similar, regardless of method. Focusing analyses on populations where PS overlap was improved (PS trimming and match weighting) did not alter conclusions. Conclusions:Attempting to equalize groups on migration selection and ADRD risk factors did not explain paradoxical findings for Mexican ancestry groups in our study.
引用
收藏
页码:495 / 504
页数:10
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