A new study indicates that the likelihood of receiving a dementia diagnosis and accessing new treatments for Alzheimer’s disease may vary depending on where someone lives. Research conducted by a team at the University of Michigan examined the percentage of people receiving a new dementia diagnosis each year in different regions of the United States. Disparities were particularly notable for individuals aged 66 to 74 and for those who are Black or Hispanic, with some regions having twice the diagnosis rate compared to others. These findings suggest that regional health system differences play a significant role in the diagnosis process.
Access to advanced diagnostic tests and treatments for dementia, which aim to slow down disease progression in the early stages, requires a formal diagnosis. The study examined regional differences in “diagnostic intensity,” which refers to variations in diagnosis rates even after accounting for factors like dementia risk and healthcare access. The research, published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, highlights the importance of diagnosis for both treatment access and specialized care and support for patients and their caregivers.
The study analyzed data from 4.8 million people covered by traditional Medicare who were over the age of 66 in 2019. While nearly 7 million Americans have a dementia diagnosis, many more likely experience symptoms without being formally diagnosed. The researchers noted that insurance coverage for biomarker tests, brain imaging scans, and dementia-slowing medications is dependent on having a diagnosis. For those who do not qualify for these treatments, a confirmed diagnosis is still crucial for accessing specialized care services.
The study revealed that regional differences in diagnosis rates could not be entirely explained by variation in dementia risk factors among different populations. Factors such as clinical practices, access to specialists, and individual care-seeking behaviors likely contribute to these discrepancies. The researchers calculated a predicted rate of diagnosis for Alzheimer’s and other forms of dementia in different regions, termed diagnostic intensity, with some areas being significantly more likely to diagnose individuals compared to the national average.
The findings suggest a need for targeted interventions to address barriers to dementia diagnosis, particularly in regions with lower-than-expected rates of diagnosis. The research highlights the importance of early identification of cognitive issues, particularly in younger Medicare participants, and the role of health systems in promoting awareness and access to cognitive assessments. Initiatives like Medicare’s GUIDE model for dementia care may offer a pathway to improving dementia care through enhanced coordination and accessibility to trained providers.
The study underscores the importance of addressing regional disparities in dementia diagnosis and highlights the need for proactive efforts to promote early detection and treatment. By identifying and addressing barriers to diagnosis, healthcare systems and communities can improve outcomes for individuals at risk of dementia. The research was funded by the National Institute on Aging, and detailed data on diagnostic intensity rates for each hospital referral region are available on the CAPRA website for further analysis and action.