Study: Black seniors with lower income, better cognitive ability less likely to get dementia diagnosis on time

Older Black adults who had less income, higher cognitive function and fewer comorbidities were less likely to be diagnosed with dementia in a timely manner, according to a new study that tried to identify which people may miss the optimal time for diagnosis in healthcare facilities. Overall, only about half the people in the study group were diagnosed in what’s considered a timely manner, which enables patients to receive proper treatment. 

The study, which was published June 27 in Alzheimer’s & Dementia, looked at five different groups of people at Rush Alzheimer’s Disease Center in Chicago. The team identified individuals with dementia based on annual assessments and looked at the timing of the diagnoses in Medicare claims. Details on each person’s sociodemographic, health and psychosocial factors were evaluated, as were years of education, race and ethnicity, and income level at midlife. 

Of 710 people with enough Medicare claims data to evaluate, 54% had a timely diagnosis within three years prior to having dementia or one year after it began; the other 46% were underdiagnosed — 60% of the underdiagnosed folks didn’t have any diagnosis during the data collection span from 1991 to 2019. All participants underwent 21 cognitive tests. The mean age at dementia onset was 87.2, and 28% of participants were men.

Data showed that Black individuals and those with better cognition at dementia onset had a higher risk for experiencing a diagnostic delay. On the flip side, those with a higher income and more comorbidities had lower odds of experiencing a delay in diagnosis.

“Both sociodemographic and health characteristics were independently related to the timeliness of dementia diagnosis,” the authors wrote.

“Our results provide initial evidence on groups of older adults who may be more susceptible to receiving a late or missed diagnosis and therefore miss the optimal window for treatment and support. Yet, how these differential opportunities may contribute to disparities in health outcomes remains unclear, and such understanding is essential for informing interventions,” the authors wrote.