A recent study found significant geographic variations in the diagnosis and treatment of dementia across the United States, with certain populations, such as Black and Hispanic individuals, and people aged 66-74, being underdiagnosed. The research analyzed Medicare Fee-for-Service records for older beneficiaries and observed differences in Alzheimer’s disease and related dementias (ADRD) diagnosis intensity among hospital referral regions. Black and Hispanic individuals, as well as those aged 66-74, had lower diagnosis intensity compared to other groups, indicating potential disparities in access to dementia care.
According to Lycia Neumann, PhD, senior director of Health Services Research at the Alzheimer’s Association of America, dementia is often underdiagnosed, especially among historically marginalized populations. Factors such as age, race/ethnicity, healthcare access, distance to clinical settings, and stigma associated with a diagnosis can contribute to these disparities. Neumann emphasized the importance of addressing these issues to improve dementia diagnosis rates in an equitable manner.
The study’s first author, Julie P. W. Bynum, MD, suggested that differences in the health systems serving communities may drive the disparities in dementia diagnosis and treatment. Factors such as primary care providers’ comfort in making a diagnosis, the availability of dementia specialists, and attitudes of patients and their families could influence diagnosis rates. Bynum also noted that issues related to healthcare access, transportation, companionship, and stigma may further complicate the diagnosis process, especially for Black and Hispanic individuals.
Neumann highlighted the importance of integrating claims data with spatial analysis to better understand disparities in access to dementia care. By identifying these disparities, educational programs and system changes can be implemented to improve diagnosis rates in an equitable manner. Neumann also mentioned advancements in diagnostic tools, such as blood tests, which may help improve access to diagnosis in the future. The Alzheimer’s Association is funding research on advanced imaging, fluid biomarkers, and blood tests to enhance diagnosis and improve overall dementia care.
To address concerns about dementia diagnosis in areas with low diagnosis rates, individuals can educate themselves on the signs of dementia and seek assistance from experts specializing in dementia care. Seeking appointments with doctors who have experience in dementia diagnosis and reaching out to community organizations, senior centers, or Alzheimer’s Association chapters for guidance can help individuals navigate the diagnosis process and access quality care. By raising awareness, improving access to diagnosis and treatment, and addressing disparities in dementia care, progress can be made towards achieving equitable healthcare for individuals with dementia across the United States.
