Medicare Beneficiaries of Color Receive Later Dementia Diagnosis Than White Counterparts

Asians, Hispanics, and blacks were less likely to receive a timely diagnosis of mild cognitive impairment or dementia compared with white beneficiaries. This is according to a study published in JAMA neurology.

Claudia H. Kawas, MD, and colleagues conducted a study of 10,472 Medicare fee-for-service beneficiaries who were continuously enrolled from Jan. 1, 2013, to Dec. 31, 2015, and had received a diagnosis of mild cognitive impairment (MCI) or dementia in the first six months of 2015.

The researchers found that Asians, Hispanics, and black beneficiaries were less likely to receive a timely diagnosis of MCI or dementia than white beneficiaries. They also found that Asian beneficiaries were less likely to receive key elements of a diagnostic evaluation, such as referral to a care provider, laboratory assays, and neuroimaging, compared with white beneficiaries (incidence rate ratio 0.81).

The study also found that older age and higher comorbidity were independently associated with late diagnosis. According to the authors, this finding highlights the importance of the United States addressing ethnic and racial disparities in health care, particularly among older patients.

“A major challenge to our understanding of dementia care is the absence of diversity in study populations engaged in research,” the authors write. “Most of what we know today about risk and protective factors for dementia, treatment effects, and biomarkers related to cognitive impairment is derived from highly educated, urban-dwelling, non-Hispanic White individuals.”

 

Source: https://jamanetwork.com/journals/jamaneurology/fullarticle/2777920 (Subscription may be required)