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Time to dementia diagnosis by race: A retrospective cohort study.

Publication ,  Journal Article
Davis, MA; Lee, KA; Harris, M; Ha, J; Langa, KM; Bynum, JPW; Hoffman, GJ
Published in: Journal of the American Geriatrics Society
November 2022

Non-Hispanic Black individuals may be less likely to receive a diagnosis of dementia compared to non-Hispanic White individuals. These findings raise important questions regarding which factors may explain this observed association and any differences in the time to which disparities emerge following dementia onset.We conducted a retrospective cohort study using survey data from the 1995 to 2016 Health and Retirement Study linked with Medicare fee-for-service claims. Using the Hurd algorithm (a regression-based approach), we identified dementia onset among older adult respondents (age ≥65 years) from the Telephone Interview for Cognitive Status and proxy respondents. We determined date from dementia onset to diagnosis using Medicare data up to 3 years following onset using a list of established diagnosis codes. Cox Proportional Hazards modeling was used to examine the association between an individual's reported race and likelihood of diagnosis after accounting for sociodemographic characteristics, income, education, functional status, and healthcare use.We identified 3435 older adults who experienced a new onset of dementia. Among them, 30.1% received a diagnosis within 36 months of onset. In unadjusted analyses, the difference in cumulative proportion diagnosed by race continued to increase across time following onset, p-value <0.001. 23.8% of non-Hispanic Black versus 31.4% of non-Hispanic White participants were diagnosed within 36 months of dementia onset, Hazard Ratio = 0.73 (95% CI: 0.61, 0.88). The association persisted after adjustment for functional status and healthcare use; however, these factors had less of an impact on the strength of the association than income and level of education.Lower diagnosis rates of dementia among non-Hispanic Black individuals persists after adjustment for sociodemographic characteristics, functional status, and healthcare use. Further understanding of barriers to diagnosis that may be related to social determinants of health is needed to improve dementia-related outcomes among non-Hispanic Black Americans.

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Published In

Journal of the American Geriatrics Society

DOI

EISSN

1532-5415

ISSN

0002-8614

Publication Date

November 2022

Volume

70

Issue

11

Start / End Page

3250 / 3259

Related Subject Headings

  • White People
  • United States
  • Retrospective Studies
  • Medicare
  • Humans
  • Geriatrics
  • Dementia
  • Black or African American
  • Aged
  • 52 Psychology
 

Citation

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Davis, M. A., Lee, K. A., Harris, M., Ha, J., Langa, K. M., Bynum, J. P. W., & Hoffman, G. J. (2022). Time to dementia diagnosis by race: A retrospective cohort study. Journal of the American Geriatrics Society, 70(11), 3250–3259. https://doi.org/10.1111/jgs.18078
Davis, Matthew A., Kathryn A. Lee, Melissa Harris, Jinkyung Ha, Kenneth M. Langa, Julie P. W. Bynum, and Geoffrey J. Hoffman. “Time to dementia diagnosis by race: A retrospective cohort study.Journal of the American Geriatrics Society 70, no. 11 (November 2022): 3250–59. https://doi.org/10.1111/jgs.18078.
Davis MA, Lee KA, Harris M, Ha J, Langa KM, Bynum JPW, et al. Time to dementia diagnosis by race: A retrospective cohort study. Journal of the American Geriatrics Society. 2022 Nov;70(11):3250–9.
Davis, Matthew A., et al. “Time to dementia diagnosis by race: A retrospective cohort study.Journal of the American Geriatrics Society, vol. 70, no. 11, Nov. 2022, pp. 3250–59. Epmc, doi:10.1111/jgs.18078.
Davis MA, Lee KA, Harris M, Ha J, Langa KM, Bynum JPW, Hoffman GJ. Time to dementia diagnosis by race: A retrospective cohort study. Journal of the American Geriatrics Society. 2022 Nov;70(11):3250–3259.
Journal cover image

Published In

Journal of the American Geriatrics Society

DOI

EISSN

1532-5415

ISSN

0002-8614

Publication Date

November 2022

Volume

70

Issue

11

Start / End Page

3250 / 3259

Related Subject Headings

  • White People
  • United States
  • Retrospective Studies
  • Medicare
  • Humans
  • Geriatrics
  • Dementia
  • Black or African American
  • Aged
  • 52 Psychology