Skip to main content
Journal cover image

Racial/ethnic disparities in dementia incidence, outcomes, and health-care utilization.

Publication ,  Journal Article
Lusk, JB; Ford, C; Clark, AG; Greiner, MA; Johnson, K; Goetz, M; Kaufman, BG; Mantri, S; Xian, Y; O'Brien, R; O'Brien, EC
Published in: Alzheimers Dement
June 2023

INTRODUCTION: Racial/ethnic disparities exist in many aspects of health care, but data on racial/ethnic disparities for neurodegenerative diseases (NDDs), such as dementia and Parkinson's disease (PD), are limited. METHODS: We used North and South Carolina Medicare claims from 2013 to 2017 to evaluate disparities in incidence of NDDs and in health-care utilization and outcomes for patients with NDDs. RESULTS: Disparities in incidence of NDD between Black and White beneficiaries narrowed by 0.37 per 100 person-years from 2014 to 2017. After thorough covariate adjustment, Black beneficiaries had a 4% higher risk of all-cause hospitalization, spent 8% more days in skilled nursing facilities and 14% fewer days in hospice facilities, were 38% less likely to receive physical/occupational therapy services, were 8% less likely to receive dementia medications, and were 19% less likely to receive PD medications than White beneficiaries. DISCUSSION: Effective system-level approaches to promote health equity in NDD diagnosis, treatment, and outcomes are clearly needed. HIGHLIGHTS: Racial disparities in neurodegenerative disease incidence narrowed between 2014 and 2017. Black patients were less likely than White patients to receive hospice services. Black patients were less likely than White patients to receive physical therapy. Black patients were less likely than White patients to receive Alzheimer's disease or Parkinson's disease medications. There is a shortage of neurologists in counties with high dementia incidence.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Alzheimers Dement

DOI

EISSN

1552-5279

Publication Date

June 2023

Volume

19

Issue

6

Start / End Page

2376 / 2388

Location

United States

Related Subject Headings

  • United States
  • Patient Acceptance of Health Care
  • Parkinson Disease
  • Neurodegenerative Diseases
  • Medicare
  • Incidence
  • Humans
  • Healthcare Disparities
  • Health Promotion
  • Health Equity
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Lusk, J. B., Ford, C., Clark, A. G., Greiner, M. A., Johnson, K., Goetz, M., … O’Brien, E. C. (2023). Racial/ethnic disparities in dementia incidence, outcomes, and health-care utilization. Alzheimers Dement, 19(6), 2376–2388. https://doi.org/10.1002/alz.12891
Lusk, Jay B., Cassie Ford, Amy G. Clark, Melissa A. Greiner, Kim Johnson, Margarethe Goetz, Brystana G. Kaufman, et al. “Racial/ethnic disparities in dementia incidence, outcomes, and health-care utilization.Alzheimers Dement 19, no. 6 (June 2023): 2376–88. https://doi.org/10.1002/alz.12891.
Lusk JB, Ford C, Clark AG, Greiner MA, Johnson K, Goetz M, et al. Racial/ethnic disparities in dementia incidence, outcomes, and health-care utilization. Alzheimers Dement. 2023 Jun;19(6):2376–88.
Lusk, Jay B., et al. “Racial/ethnic disparities in dementia incidence, outcomes, and health-care utilization.Alzheimers Dement, vol. 19, no. 6, June 2023, pp. 2376–88. Pubmed, doi:10.1002/alz.12891.
Lusk JB, Ford C, Clark AG, Greiner MA, Johnson K, Goetz M, Kaufman BG, Mantri S, Xian Y, O’Brien R, O’Brien EC. Racial/ethnic disparities in dementia incidence, outcomes, and health-care utilization. Alzheimers Dement. 2023 Jun;19(6):2376–2388.
Journal cover image

Published In

Alzheimers Dement

DOI

EISSN

1552-5279

Publication Date

June 2023

Volume

19

Issue

6

Start / End Page

2376 / 2388

Location

United States

Related Subject Headings

  • United States
  • Patient Acceptance of Health Care
  • Parkinson Disease
  • Neurodegenerative Diseases
  • Medicare
  • Incidence
  • Humans
  • Healthcare Disparities
  • Health Promotion
  • Health Equity