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Racial and ethnic disparities in the treatment of dementia among Medicare beneficiaries
Zuckerman IH, Ryder PT, Simoni-Wastila L, Shaffer T, Sato M, Zhao L, Stuart B.. The journals of gerontology. Series B, Psychological sciences and social sciences, 2008-09-01
Topic: Risk, prevention and care in population studies
Objectives Numerous studies have documented disparities in health care utilization between non-Hispanic White and minority elders. We investigated differences in anti-dementia medication use between non-Hispanic White and minority community-dwelling Medicare beneficiaries with dementia. Methods Using multivariate analysis with generalized estimating equations, we estimated prevalence ratios (PRs) for anti-dementia medication use by race/ethnicity for 1,120 beneficiaries with dementia from years 2001 through 2003 of the Medicare Current Beneficiary Survey. Results After adjusting for demographics, socioeconomics, health care access and utilization, comorbidities, and service year, we found that anti-dementia medication use was approximately 30% higher among non-Hispanic Whites compared to other racial/ethnic groups (PR=0.73, 95% confidence interval [CI]=0.59, 0.91). As for individual racial/ethnic groups, prevalence disparities remained significant for non-Hispanic Blacks (PR=0.75, 95% CI=0.57, 0.99) and non-Hispanic others (PR=0.50, 95% CI=0.26, 0.96) but were attenuated for Hispanics (PR=0.84, 95% CI=0.59, 1.20). Discussion Results provide evidence that racial/ethnic disparities in utilization of drugs used to treat dementia exist and are not accounted for by differences in demographic, economic, health status, or health utilization factors. Findings provide a foundation for further research that should use larger numbers of minority patients and consider dementia type and severity, access to specialty dementia care, and cultural factors.
Key findings
- Results After adjusting for demographics, socioeconomics, health care access and utilization, comorbidities, and service year, we found that anti-dementia medication use was approximately 30% higher among non-Hispanic Whites compared to other racial/ethnic groups (PR=0.73, 95% confidence interval [CI]=0.59, 0.91).
- As for individual racial/ethnic groups, prevalence disparities remained significant for non-Hispanic Blacks (PR=0.75, 95% CI=0.57, 0.99) and non-Hispanic others (PR=0.50, 95% CI=0.26, 0.96) but were attenuated for Hispanics (PR=0.84, 95% CI=0.59, 1.20).
- Discussion Results provide evidence that racial/ethnic disparities in utilization of drugs used to treat dementia exist and are not accounted for by differences in demographic, economic, health status, or health utilization factors.
Why it matters
In 1,120 community-dwelling Medicare beneficiaries with dementia (2001–2003 survey data), minority beneficiaries were less likely than non-Hispanic Whites to use anti-dementia medication (prevalence ratio 0.73), even after accounting for income, health care access, other illnesses and demographics. The gap was clear for non-Hispanic Black and "other" beneficiaries but inconclusive for Hispanic beneficiaries. This shows unequal use of existing dementia drugs, not why it happens, and is not evidence about any treatment's benefit.
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Study details
- Evidence strengthLow
How this study scored 40/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (The journals of gerontology. Series B, Psychological sciences and social sciences) |
| Journal's citation record | 2 / 4 | The Journals of Gerontology Series B: journal h-index 225 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2008 — within 20 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 102 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 5.1 citations a year over 20 year(s) since 2008 |
| Impact for its field and year | 2 / 6 | Cited 2.3× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 14 other studies in this library |
| Still being cited | 2 / 4 | Cited 16 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 1 / 4 | Last-listed author B. Stuart: h-index 5 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | University of Maryland, Baltimore: institution h-index 970 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 18818454) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 40 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1093/geronb/63.5.s328
- PubMed: 18818454
- Original source →
- Free full text: The Journals of Gerontology Series B →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
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 7 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.
APA 7th
Zuckerman, I. H., Ryder, P. T., Simoni-Wastila, L., Shaffer, T., Sato, M., Zhao, L., et al. (2008). Racial and ethnic disparities in the treatment of dementia among Medicare beneficiaries. The journals of gerontology. Series B, Psychological sciences and social sciences. https://doi.org/10.1093/geronb/63.5.s328
Vancouver
Zuckerman IH, Ryder PT, Simoni-Wastila L, Shaffer T, Sato M, Zhao L, et al. Racial and ethnic disparities in the treatment of dementia among Medicare beneficiaries. The journals of gerontology. Series B, Psychological sciences and social sciences. 2008. doi:10.1093/geronb/63.5.s328. PMID: 18818454.
BibTeX
@article{zuckerman2008-18818454,
author = {Zuckerman, I. H. and Ryder, P. T. and Simoni-Wastila, L. and Shaffer, T. and Sato, M. and Zhao, L. and Stuart, B.},
title = {{Racial and ethnic disparities in the treatment of dementia among Medicare beneficiaries}},
journal = {The journals of gerontology. Series B, Psychological sciences and social sciences},
year = {2008},
doi = {10.1093/geronb/63.5.s328},
pmid = {18818454},
url = {https://doi.org/10.1093/geronb/63.5.s328}
}
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