Title | Racial disparities and temporal trends in dementia misdiagnosis risk in the United States |
Publication Type | Journal Article |
Year of Publication | 2019 |
Authors | Gianattasio, KZ, Prather, C, M. Glymour, M, Ciarleglio, A, Power, MC |
Journal | Alzheimer's and Dementia: Translational Research and Clinical Interventions |
Volume | 5 |
Pagination | 891-898 |
ISSN Number | 23528737 |
Keywords | Aged, algorithm, ancestry group, Article, Black person, Caucasian, Dementia, diagnostic error, ethnic group, Female, health disparity, human, ICD-9-CM, major clinical study, Male, Medicare, priority journal, Retirement, risk factor, sensitivity analysis, Sensitivity and Specificity, United States |
Abstract | Introduction: Systematic disparities in misdiagnosis of dementia across racial/ethnic groups have implications for health disparities. We compared the risk of dementia under- and overdiagnosis in clinical settings across racial/ethnic groups from 2000 to 2010. Methods: We linked fee-for-service Medicare claims to participants aged ≥70 from the nationally representative Health and Retirement Study. We classified dementia status using an algorithm with similar sensitivity and specificity across racial/ethnic groups and assigned clinical dementia diagnosis status using ICD-9-CM codes from Medicare claims. Multinomial logit models were used to estimate relative risks of clinical under- and overdiagnosis between groups and over time. Results: Non-Hispanic blacks had roughly double the risk of underdiagnosis as non-Hispanic whites. While primary analyses suggested a shrinking disparity over time, this was not robust to sensitivity analyses or adjustment for covariates. Risk of overdiagnosis increased over time in both groups. Discussion: Our results suggest that efforts to reduce racial disparities in underdiagnosis are warranted. © 2019 The Authors |
DOI | 10.1016/j.trci.2019.11.008 |
Citation Key | Gianattasio2019891 |
PubMed ID | 31890853 |
PubMed Central ID | PMC6926355 |