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Dementia Diagnosis Disparities by Race and Ethnicity
Lin PJ, Daly AT, Olchanski N, Cohen JT, Neumann PJ, Faul JD, Fillit HM, Freund KM.. Medical care, 2021-08-01
Topic: Risk, prevention and care in population studies
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 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.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Lin, P. J., Daly, A. T., Olchanski, N., Cohen, J. T., Neumann, P. J., Faul, J. D., et al. (2021). Dementia Diagnosis Disparities by Race and Ethnicity. Medical care. https://doi.org/10.1097/mlr.0000000000001577
Vancouver
Lin PJ, Daly AT, Olchanski N, Cohen JT, Neumann PJ, Faul JD, et al. Dementia Diagnosis Disparities by Race and Ethnicity. Medical care. 2021. doi:10.1097/mlr.0000000000001577. PMID: 34091580.
BibTeX
@article{lin2021-34091580,
author = {Lin, P. J. and Daly, A. T. and Olchanski, N. and Cohen, J. T. and Neumann, P. J. and Faul, J. D. and Fillit, H. M. and Freund, K. M.},
title = {{Dementia Diagnosis Disparities by Race and Ethnicity}},
journal = {Medical care},
year = {2021},
doi = {10.1097/mlr.0000000000001577},
pmid = {34091580},
url = {https://doi.org/10.1097/mlr.0000000000001577}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 8 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
Key findings
- 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).
Why it matters
Among 3,966 adults aged 70 and older with probable dementia in the Health and Retirement Study, a missed or delayed dementia diagnosis in Medicare/Medicaid claims was more common for Hispanic (54%) and non-Hispanic Black (46%) participants than for non-Hispanic White participants (41%). The authors conclude that Black and Hispanic older adults "may" also face longer diagnosis delays and have more advanced dementia when diagnosed, and that early-diagnosis efforts should prioritise these communities. This is a comparison of groups and does not show why the gaps exist; it is about timely diagnosis, not treating, curing or preventing Alzheimer's disease.
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Study details
- Study designcohort study
- Participants3,966
- Evidence strengthModerate
How this study scored 67/100
Published in a peer-reviewed journal, and it is a cohort study following people over time. Scored zero for effect reported and randomized / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Medical care) |
| Journal's citation record | 3 / 4 | Medical Care: journal h-index 273 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A cohort study following people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 3 / 5 | 2021 — within 6 year(s) of the newest study here |
| Sample size | 3 / 4 | 3,966 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 240 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 34.3 citations a year over 7 year(s) since 2021 |
| Impact for its field and year | 4 / 6 | Cited 18.9× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 4 / 6 | Cited by 39 other studies in this library |
| Still being cited | 3 / 4 | Cited 183 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Karen M. Freund: h-index 49 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of Michigan: institution h-index 2,240 (OpenAlex) |
| Multicenter collaboration | 2 / 3 | OpenAlex lists 5 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 34091580) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 67 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1097/mlr.0000000000001577
- PubMed: 34091580
- Original source →
- Free full text: PubMed Central →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
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