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Economics Research: Publications since January 2022

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%% Yashkin, Arseniy   
   Author = {Akushevich, I and Yashkin, A and Kovtun, M and Yashin, AI and Kravchenko, J},
   Title = {Underlying mechanisms of change in cancer prevalence in
             older U.S. adults: contributions of incidence, survival, and
             ascertainment at early stages.},
   Journal = {Cancer Causes Control},
   Volume = {33},
   Number = {9},
   Pages = {1161-1172},
   Year = {2022},
   Month = {September},
   url = {},
   Abstract = {PURPOSE: To quantitatively evaluate contributions of trends
             in incidence, relative survival, and stage at diagnosis to
             the dynamics in the prevalence of major cancers (lung,
             prostate, colon, breast, urinary bladder, ovaries, stomach,
             pancreas, esophagus, kidney, liver, and skin melanoma) among
             older U.S. adults age 65 +. METHODS: Trend partitioning
             was applied to the Surveillance, Epidemiology, and End
             Results Program data for 1973-2016. RESULTS: Growth of
             cancer prevalence in older adults decelerated or even
             decreased over time for all studied cancers due to
             decreasing incidence and improving survival for most of
             cancers, with a smaller contribution of the stage at cancer
             diagnosis. Changes in the prevalence of cancers of the lung,
             colon, stomach, and breast were predominantly due to
             decreasing incidence, increasing survival and more frequent
             diagnoses at earlier stages. Changes in prevalence of some
             other cancers demonstrated adverse trends such as decreasing
             survival in localized and regional stages (urinary bladder
             and ovarian) and growing impact of late-stage diagnoses
             (esophageal cancer). CONCLUSION: While decelerating or
             decreasing prevalence of many cancers were due to a
             beneficial combination of decreasing incidence and
             increasing survival, there are cancers for which
             decelerating prevalence is due to lack of improvement in
             their stage-specific survival and/or increasing frequency of
             diagnosis at advanced stages. Overall, if the observed
             trends persist, it is likely that the burden associated with
             cancer prevalence in older U.S. adults will be lower
              comparing to projections based on constant increasing
             prevalence have previously estimated.},
   Doi = {10.1007/s10552-022-01595-6},
   Key = {fds364200}

   Author = {Akushevich, I and Kolpakov, S and Yashkin, AP and Kravchenko,
   Title = {Vulnerability to Hypertension Is a Major Determinant of
             Racial Disparities in Alzheimer's Disease
   Journal = {Am J Hypertens},
   Volume = {35},
   Number = {8},
   Pages = {745-751},
   Year = {2022},
   Month = {August},
   url = {},
   Abstract = {BACKGROUND: Higher incidence levels of Alzheimer's disease
             (AD) in Black Americans are well documented. However,
             quantitative explanations of this disparity in terms of
             risk-factor diseases acting through well-defined pathways
             are lacking. METHODS: We applied a Blinder-Oaxaca-based
             algorithm modified for censored data to a 5% random sample
             of Medicare beneficiaries age 65+ to explain Black/White
             disparities in AD risk in terms of differences in exposure
             and vulnerability to morbidity profiles based on 10 major
             AD-risk-related diseases. RESULTS: The primary contribution
             to racial disparities in AD risk comes from morbidity
             profiles that included hypertension with about 1/5th of
             their contribution due to differences in prevalence
             (exposure effect) and 4/5ths to differences in the effects
             of the morbidity profile on AD risk (vulnerability effect).
             In total, disease-related effects explained a higher
             proportion of AD incidence in Black Americans than in their
             White counterparts. CONCLUSIONS: Disease-related causes may
             represent some of the most straightforward targets for
             targeted interventions aimed at the reduction of racial
             disparities in health among US older adults. Hypertension is
             a manageable and potentially preventable condition
             responsible for the majority of the Black/White differences
             in AD risk, making mitigation of the role of this disease in
             engendering higher AD incidence in Black Americans a
             prominent concern.},
   Doi = {10.1093/ajh/hpac063},
   Key = {fds365173}

   Author = {Akushevich, I and Yashkin, AP and Kravchenko, J and Kertai,
   Title = {Extended anesthesia exposure for abdominal and pelvic
             procedures in older adults with colorectal cancer:
             Associations with chart dementia diagnoses.},
   Journal = {Exp Gerontol},
   Volume = {164},
   Pages = {111830},
   Year = {2022},
   Month = {July},
   url = {},
   Abstract = {BACKGROUND: We hypothesized that cumulative anesthesia
             exposure over the course of routine treatment of colorectal
             cancer in older adults can increase long-term risk of
             Alzheimer's disease (AD), Alzheimer's disease-related
             dementias (ADRD), and other chronic neurocognitive disorders
             (CND). METHODS: We conducted a SEER-Medicare-based
             retrospective cohort study of 84,770 individuals age
             65 years and older diagnosed with colorectal cancer between
             1998 and 2007 using a proportional hazards model with
             inverse probability weighted estimators. The primary
             exploratory variable was a time-variant measure of
             cumulative anesthesia exposure for abdominal and pelvic
             procedures, updated continuously. RESULTS: Our primary
             outcomes, AD and ADRD, occurred in 6005/84,770 (7.1%) and
             14,414/83,444 (17.3%) individuals respectively. No
             statistically significant association was found between
             cumulative anesthesia exposure and AD (hazard ratio [HR],
             0.993; 95% CI, 0.973-1.013). However, it was moderately
             associated with the risk of ADRD (HR, 1.016; 95% CI,
             1.004-1.029) and some secondary outcomes including most
             notably: cerebral degeneration (HR, 1.048; 95% CI,
             1.033-1.063), hepatic encephalopathy (HR, 1.133; 95% CI,
             1.101-1.167), encephalopathy-not elsewhere classified
             (HR,1.095; 95% CI: 1.076-1.115), and incident/perioperative
             delirium (HR, 1.022; 95% CI, 1.012-1.032). Furthermore, we
             observed an association between perioperative delirium and
             increased risk of AD (HR, 2.05; 95% CI, 1.92-2.09).
             CONCLUSION: Cumulative anesthesia exposure for abdominal and
             pelvic procedures was not associated with increased risk of
             AD directly and had a small but statistically significant
             association with ADRD and a number of other CNDs. Cumulative
             anesthesia exposure was also associated with perioperative
             delirium, which had an independent adverse association with
             AD risk.},
   Doi = {10.1016/j.exger.2022.111830},
   Key = {fds363366}

   Author = {Yu, B and Akushevich, I and Yashkin, AP and Yashin, AI and Lyerly, HK and Kravchenko, J},
   Title = {Epidemiology of geographic disparities in heart failure
             among US older adults: a Medicare-based analysis.},
   Journal = {Bmc Public Health},
   Volume = {22},
   Number = {1},
   Pages = {1280},
   Year = {2022},
   Month = {July},
   url = {},
   Abstract = {BACKGROUND: There are prominent geographic disparities in
             the life expectancy (LE) of older US adults between the
             states with the highest (leading states) and lowest
             (lagging states) LE and their causes remain poorly
             understood. Heart failure (HF) has been proposed as a major
             contributor to these disparities. This study aims to
             investigate geographic disparities in HF outcomes between
             the leading and lagging states. METHODS: The study was a
             secondary data analysis of HF outcomes in older US adults
             aged 65+, using Center for Disease Control and Prevention
             sponsored Wide-Ranging Online Data for Epidemiologic
             Research (CDC WONDER) database and a nationally
             representative 5% sample of Medicare beneficiaries over
             2000-2017. Empiric estimates of death certificate-based
             mortality from HF as underlying cause of death
             (CBM-UCD)/multiple cause of death (CBM-MCD); HF
             incidence-based mortality (IBM); HF incidence, prevalence,
             and survival were compared between the leading and lagging
             states. Cox regression was used to investigate the effect of
             residence in the lagging states on HF incidence and
             survival. RESULTS: Between 2000 and 2017, HF mortality rates
             (per 100,000) were higher in the lagging states (CBM-UCD:
             188.5-248.6; CBM-MCD: 749.4-965.9; IBM: 2656.0-2978.4) than
             that in the leading states (CBM-UCD: 79.4-95.6; CBM-MCD:
             441.4-574.1; IBM: 1839.5-2138.1). Compared to their leading
             counterparts, lagging states had higher HF incidence
             (2.9-3.9% vs. 2.2-2.9%), prevalence (15.6-17.2% vs.
             11.3-13.0%), and pre-existing prevalence at age 65 (5.3-7.3%
             vs. 2.8-4.1%). The most recent rates of one- (77.1% vs.
             80.4%), three- (59.0% vs. 60.7%) and five-year (45.8% vs.
             49.8%) survival were lower in the lagging states. A greater
             risk of HF incidence (Adjusted Hazards Ratio, AHR [95%CI]:
             1.29 [1.29-1.30]) and death after HF diagnosis (AHR: 1.12
             [1.11-1.13]) was observed for populations in the lagging
             states. The study also observed recent increases in CBMs
             and HF incidence, and declines in HF prevalence,
             prevalence at age 65 and survival with a decade-long plateau
             stage in IBM in both leading and lagging states. CONCLUSION:
             There are substantial geographic disparities in HF
             mortality, incidence, prevalence, and survival across the
             U.S.: HF incidence, prevalence at age 65 (age of Medicare
             enrollment), and survival of patients with HF contributed
             most to these disparities. The geographic disparities and
             the recent increase in incidence and decline in survival
             underscore the importance of HF prevention
   Doi = {10.1186/s12889-022-13639-2},
   Key = {fds363974}

   Author = {Nazarian, A and Arbeev, KG and Yashkin, AP and Kulminski,
   Title = {Genome-wide analysis of genetic predisposition to common
             polygenic cancers.},
   Journal = {Journal of Applied Genetics},
   Volume = {63},
   Number = {2},
   Pages = {315-325},
   Year = {2022},
   Month = {May},
   url = {},
   Abstract = {Lung, breast, prostate, and colorectal cancers are among the
             most common and fatal malignancies worldwide. They are
             mainly caused by multifactorial mechanisms and are
             genetically heterogeneous. We investigated the genetic
             architecture of these cancers through genome-wide
             association, pathway-based, and summary-based transcriptome-/methylome-wide
             association analyses using three independent cohorts. Our
             genome-wide association analyses identified the associations
             of 33 single-nucleotide polymorphisms (SNPs) at
             P < 5E - 06, of which 32 SNPs were not previously
             reported and did not have proxy variants within
             their ± 1 Mb flanking regions. Moreover, other
             polymorphisms mapped to their closest genes were not
             previously associated with the same cancers at
             P < 5E - 06. Our pathway enrichment analyses
             revealed associations of 32 pathways; mainly related to the
             immune system, DNA replication/transcription, and
             chromosomal organization; with the studied cancers. Also, 60
             probes were associated with these cancers in our
             transcriptome-wide and methylome-wide analyses.
             The ± 1 Mb flanking regions of most probes had not
             attained P < 5E - 06 in genome-wide association
             studies. The genes corresponding to the significant probes
             can be considered as potential targets for further
             functional studies. Two genes (i.e., CDC14A and PMEL)
             demonstrated stronger evidence of associations with lung
             cancer as they had significant probes in both
             transcriptome-wide and methylome-wide association analyses.
             The novel cancer-associated SNPs and genes identified here
             would advance our understanding of the genetic heterogeneity
             of the common cancers.},
   Doi = {10.1007/s13353-021-00679-4},
   Key = {fds361336}

   Author = {Gary, KM and Hoque, M and Yashkin, AP and Yashin, AI and Akushevich,
   Title = {Does the Chronic Stress of Everyday Discrimination or Race
             Itself Better Predict AD Onset Risk?},
   Journal = {Gerontology & Geriatric Medicine},
   Volume = {8},
   Pages = {23337214221142944},
   Year = {2022},
   Month = {January},
   url = {},
   Abstract = {Using evidence from the Health and Retirement Study, we
             explore racial disparities in Alzheimer's Disease (AD) onset
             risk. From a stress process perspective, there is
             substantial evidence in the literature that everyday
             discrimination is a chronic strain for Black individuals
             that acts as a social determinant of illness. However, few
             studies have examined specific relationships between this
             social stressor, race, and AD onset risk. Using Cox
             Proportional Hazard Models, we examined racial differences
             in exposure and vulnerability to everyday discrimination.
             Findings suggest that everyday discrimination predicts AD
             onset risk, and Black individuals experience more frequent
             exposure to everyday discrimination as a chronic strain.
             However, contrary to the stress process model, Black
             respondents were not more vulnerable to the effect of
             everyday discrimination on AD onset risk. Racial bias from
             medical professionals during the diagnostic process and
             mortality selection bias may explain this effect. Overall,
             the results of this study provide further evidence that
             discrimination is a key factor in predicting AD while also
             considering that many racial minorities with high rates of
             this type of social stress may not receive an unbiased
             diagnosis and/or survive to late life to develop
   Doi = {10.1177/23337214221142944},
   Key = {fds368508}

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