Correlates of missed or late versus timely diagnosis of dementia in healthcare settings
Document Type
Journal Article
Publication Date
6-27-2024
Journal
Alzheimer's & dementia : the journal of the Alzheimer's Association
DOI
10.1002/alz.14067
Keywords
dementia; disparities; healthcare; timely diagnosis
Abstract
INTRODUCTION: There is limited evidence about factors related to the timeliness of dementia diagnosis in healthcare settings. METHODS: In five prospective cohorts at Rush Alzheimer's Disease Center, we identified participants with incident dementia based on annual assessments and examined the timing of healthcare diagnoses in Medicare claims. We assessed sociodemographic, health, and psychosocial correlates of timely diagnosis. RESULTS: Of 710 participants, 385 (or 54%) received a timely claims diagnosis within 3 years prior to or 1 year following dementia onset. In logistic regressions accounting for demographics, we found Black participants (odds ratio [OR] = 2.15, 95% confidence interval [CI]: 1.21 to 3.82) and those with better cognition at dementia onset (OR = 1.48, 95% CI: 1.10 to 1.98) were at higher odds of experiencing a diagnostic delay, whereas participants with higher income (OR = 0.89, 95% CI: 0.81 to 0.97) and more comorbidities (OR = 0.94, 95% CI: 0.89 to 0.98) had lower odds. DISCUSSION: We identified characteristics of individuals who may miss the optimal window for dementia treatment and support. HIGHLIGHTS: We compared the timing of healthcare diagnosis relative to the timing of incident dementia based on rigorous annual evaluation. Older Black adults with lower income, higher cognitive function, and fewer comorbidities were less likely to be diagnosed in a timely manner by the healthcare system.
APA Citation
Chen, Yi; Power, Melinda C.; Grodstein, Francine; Capuano, Ana W.; Lange-Maia, Brittney S.; Moghtaderi, Ali; Stapp, Emma K.; Bhattacharyya, Joya; Shah, Raj C.; Barnes, Lisa L.; Marquez, David X.; Bennett, David A.; and James, Bryan D., "Correlates of missed or late versus timely diagnosis of dementia in healthcare settings" (2024). GW Authored Works. Paper 5042.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/5042
Department
Epidemiology