@article {11742, title = {Dementia Diagnosis Disparities by Race and Ethnicity.}, journal = {Medical Care}, volume = {59}, year = {2021}, pages = {679-686}, abstract = {

BACKGROUND: Dementia is often underdiagnosed and this problem is more common among some ethnoracial groups.

OBJECTIVE: The objective of this study was to examine racial and ethnic disparities in the timeliness of receiving a clinical diagnosis of dementia.

RESEARCH DESIGN: This was a prospective cohort study.

SUBJECTS: A total of 3966 participants age 70 years and above with probable dementia in the Health and Retirement Study, linked with their Medicare and Medicaid claims.

MEASURES: We performed logistic regression to compare the likelihood of having a missed or delayed dementia diagnosis in claims by race/ethnicity. We analyzed dementia severity, measured by cognition and daily function, at the time of a dementia diagnosis documented in claims, and estimated average dementia diagnosis delay, by race/ethnicity.

RESULTS: A higher proportion of non-Hispanic Blacks and Hispanics had a missed/delayed clinical dementia diagnosis compared with non-Hispanic Whites (46\% and 54\% vs. 41\%, P<0.001). Fully adjusted logistic regression results suggested more frequent missed/delayed dementia diagnoses among non-Hispanic Blacks (odds ratio=1.12; 95\% confidence interval: 0.91-1.38) and Hispanics (odds ratio=1.58; 95\% confidence interval: 1.20-2.07). Non-Hispanic Blacks and Hispanics had a poorer cognitive function and more functional limitations than non-Hispanic Whites around the time of receiving a claims-based dementia diagnosis. The estimated mean diagnosis delay was 34.6 months for non-Hispanic Blacks and 43.8 months for Hispanics, compared with 31.2 months for non-Hispanic Whites.

CONCLUSIONS: Non-Hispanic Blacks and Hispanics may experience a missed or delayed diagnosis of dementia more often and have longer diagnosis delays. When diagnosed, non-Hispanic Blacks and Hispanics may have more advanced dementia. Public health efforts should prioritize racial and ethnic underrepresented communities when promoting early diagnosis of dementia.

}, keywords = {dementia diagnosis, Racial Disparities}, issn = {1537-1948}, doi = {10.1097/MLR.0000000000001577}, author = {Lin, Pei-Jung and Allan T Daly and Olchanski, Natalia and Joshua T Cohen and Peter J Neumann and Jessica Faul and Howard M Fillit and Karen M Freund} }