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TOPLINE:

Black and Hispanic older adults were less likely to receive a timely diagnosis of dementia than their White counterparts. Lower level of education was a primary mediator of 48.4%-61.9% of this disparity, and affluence of the neighborhood and access to local healthcare explained additional proportions.

METHODOLOGY:

• Researchers conducted a retrospective observational study to assess factors that explain racial and ethnic differences in the timely diagnosis of dementia in older adults.
• They assessed 3429 US adults aged 65 years or older with dementia, using data from the Health and Retirement Study (1998-2020) linked to Medicare claims (1995-2021).
• The primary outcome was a timely diagnosis of dementia, defined as a diagnosis recorded in claims 3 years prior or 1 year after when dementia was first observed.
• Race and ethnicity were reported by individuals. Researchers evaluated factors at the individual and neighborhood levels and related to access to healthcare.

TAKEAWAY:

• Overall, 53.4% of older adults received a timely diagnosis of dementia.
• Black older adults were 29% less likely and Hispanic older adults were 39% less likely to receive a timely diagnosis than their White peers (P < .01 for both) in an adjusted analysis.
• Having at least high school education was the most prominent mediator, accounting for 48.4% of the disparity for Black adults and 61.9% for Hispanic older adults.
• Living in affluent neighborhoods and having a greater number of local healthcare practitioner and physician offices were also mediators of the remaining disparities.
• Income and neighborhood disadvantage were not significant mediators, suggesting that differential financial resources alone do not drive diagnostic disparities.

IN PRACTICE:

“Without a universal cognitive screening recommendation in the US and given disproportionately high dementia incidence among Black and Hispanic older adults, our findings point to important directions for targeted intervention to improve timely dementia detection and advance equity in dementia care,” the researchers of the study wrote.

SOURCE:

The study was led by Yuting Qian, PhD, of Yale University in New Haven, Connecticut. It was published online on May 1 in the Journal of General Internal Medicine.

LIMITATIONS:

Researchers used an algorithm to identify dementia rather than clinical diagnoses.

DISCLOSURES:

The study received support from grants from the National Institute on Aging and the Patient-Centered Outcomes Research Institute. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.