The diagnosis and treatment of dementia across the United States vary widely, with certain populations such as Black and Hispanic individuals, and individuals aged 66-74 being underdiagnosed. A new study published in Alzheimer’s & Dementia found that the intensity of Alzheimer’s disease and related dementias (ADRD) diagnosis differed across different U.S. regions, ranging from 0.69 to 1.47 among hospital referral regions. This disparity persisted regardless of population risk factors such as education level, obesity, smoking habits, and a diagnosis of diabetes.
According to the study, Black and Hispanic individuals, as well as those aged 66-74 years, had the lowest intensity of ADRD diagnosis. Factors contributing to this disparity may include differences in health systems serving these communities, the confidence and comfort levels of primary care providers in making a diagnosis, and the availability of dementia specialists to assist with challenging cases. The attitudes of patients and their families, as well as social determinants of health such as lack of healthcare access, stigma associated with a diagnosis, and fear of the impact on livelihood, may also play a role in underdiagnosis.
While it is less common for younger people to be diagnosed with dementia, the diagnosis can be tricky to make in earlier stages when symptoms may be subtle and have other contributing factors, such as depression. Apart from healthcare access issues, there may be barriers to seeking a diagnosis for fear of stigma or implications on one’s job. However, Bynum and Neumann both believe that the study provides crucial data that may help address these disparities and lead to an equitable solution.
Neumann emphasized the importance of integrating claims data with spatial analysis to understand disparities in access to dementia care, starting with diagnosis. She highlighted the need for objective data to inform educational programs and system changes that can improve diagnosis rates in an equitable manner. While the study is based on data from 2018-2019, advancements in diagnostic tools such as blood tests may improve access to diagnosis in the future. The Alzheimer’s Association is actively working to increase awareness of dementia signs, symptoms, and improve access to diagnosis, treatment, and care.
For individuals living in areas where concerns about a dementia diagnosis are not being adequately addressed, seeking assistance from experts specializing in caring for patients with dementia may be necessary. Beyond educating themselves on dementia signs, individuals may need to seek guidance from community organizations serving the elderly or centers that provide support. Local Alzheimer’s Association chapters may also offer resources and assistance to individuals seeking a diagnosis for themselves or their family members, to ensure they receive the necessary care and support.
