{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T11:29:15Z","timestamp":1781954955709,"version":"3.54.5"},"reference-count":60,"publisher":"SAGE Publications","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JHD"],"published-print":{"date-parts":[[2022,3,1]]},"abstract":"<jats:p>Background: Huntington\u2019s Disease Society of America Centers of Excellence (HDSA COEs) are primary hubs for Huntington\u2019s disease (HD) research opportunities and accessing new treatments. Data on the extent to which HDSA COEs are accessible to individuals with HD, particularly those older or disabled, are lacking. Objective: To describe persons with HD in the U.S. Medicare program and characterize this population by proximity to an HDSA COE. Methods: We conducted a cross-sectional study of Medicare beneficiaries ages \u226565 with HD in 2017. We analyzed data on benefit entitlement, demographics, and comorbidities. QGis software and Google Maps Interface were employed to estimate the distance from each patient to the nearest HDSA COE, and the proportion of individuals residing within 100 miles of these COEs at the state level. Results: Among 9,056 Medicare beneficiaries with HD, 54.5% were female, 83.0% were white; 48.5% were \u226565 years, but 64.9% originally qualified for Medicare due to disability. Common comorbidities were dementia (32.4%) and depression (35.9%), and these were more common in HD vs. non-HD patients. Overall, 5,144 (57.1%) lived within 100 miles of a COE. Race\/ethnicity, sex, age, and poverty markers were not associated with below-average proximity to HDSA COEs. The proportion of patients living within 100 miles of a center varied from &lt;\u200a10% (16 states) to &gt;\u200a90% (7 states). Most underserved states were in the Mountain and West Central divisions. Conclusion: Older Medicare beneficiaries with HD are frequently disabled and have a distinct comorbidity profile. Geographical, rather than sociodemographic factors, define the HD population with limited access to HDSA COEs.<\/jats:p>","DOI":"10.3233\/jhd-210489","type":"journal-article","created":{"date-parts":[[2022,3,1]],"date-time":"2022-03-01T13:27:42Z","timestamp":1646141262000},"page":"81-89","source":"Crossref","is-referenced-by-count":12,"title":["Geographic Barriers Drive Disparities in Specialty Center Access for Older Adults with Huntington\u2019s Disease"],"prefix":"10.1177","volume":"11","author":[{"given":"Thanh Phuong","family":"Pham Nguyen","sequence":"first","affiliation":[{"name":"Center for Pharmacoepidemiology Research and Training, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA"},{"name":"Center for Clinical Epidemiology and Biostatistics, Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA"},{"name":"Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA"},{"name":"Department of Neurology Translational Center for Excellence for Neuroepidemiology and Neurological Outcomes Research, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Licia","family":"Bravo","sequence":"additional","affiliation":[{"name":"Xavier University of Louisiana, New Orleans, LA, USA"},{"name":"Penn Access Summer Scholars Program, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro","family":"Gonzalez-Alegre","sequence":"additional","affiliation":[{"name":"Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA"},{"name":"Raymond G. Perelman Center for Cellular & Molecular Therapy, The Children\u2019s Hospital of Philadelphia, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison W.","family":"Willis","sequence":"additional","affiliation":[{"name":"Center for Pharmacoepidemiology Research and Training, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA"},{"name":"Center for Clinical Epidemiology and Biostatistics, Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA"},{"name":"Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA"},{"name":"Department of Neurology Translational Center for Excellence for Neuroepidemiology and Neurological Outcomes Research, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA"},{"name":"Leonard Davis 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