Non-Hispanic Black older adults are less likely to receive a diagnosis of dementia than non-Hispanic white older adults, according to a new study. The findings support a growing body of evidence that race influences dementia diagnosis, investigators say.
The researchers conducted a retrospective cohort study using survey data from the 1995 to 2016 Health and Retirement Study. The data was linked with Medicare fee-for-service claims. They determined the date from dementia onset to diagnosis using Medicare data up to three years following onset using a list of established diagnosis codes.
After accounting for factors such as sociodemographic characteristics, income, education, functional status and healthcare use, they examined links between a patient’s reported race and likelihood of a diagnosis.
Among more than 3,400 study participants aged 65 years and older, 24% of non-Hispanic Black versus 31% of non-Hispanic White participants were diagnosed within 36 months of dementia onset, investigators reported. These differences in diagnosis rates persisted for three years after the onset of dementia. Income and level of education were strongly associated with diagnosis, followed by functional status and healthcare use.
Overall, the study results “identify differences by race in Alzheimer’s disease and related dementia diagnosis even after accounting for commonly observed facilitators or barriers to healthcare use and quality of care, potentially suggesting embedded disparities in care systems,” the authors concluded.
Full findings were published in the Journal of the American Geriatrics Society.