• Posted August 3, 2023

Memory Troubles? Your Race Could Affect How Soon You Get Diagnosis, Treatment

Black Americans are less likely to be seen at a memory clinic than their white peers. So too are folks from neighborhoods that are poor and lack educational and job opportunities, according to a new study.

That could mean later diagnosis and treatment for dementias like Alzheimer's disease.

The research, published online Aug. 2 in Neurology, involved data from more than 4,800 people seen at a memory care clinic at Washington University in St. Louis over 10 years. Of those, 11% were Black and 89% were white.

Researchers looked at the severity of dementia when people were first evaluated at the clinic. They also looked at home addresses and a measure called the Area Deprivation Index, which ranks neighborhoods based on 17 indicators, including income, employment, education and housing quality.

The study found that people seen at the clinic tended to live in more advantaged neighborhoods.

They had an average score of 45 on the area deprivation index, compared to an average score of 65 for the entire population in that area. Higher scores on this index indicate more neighborhood disadvantage.

Though 16% of people in the service area were Black, they represented 11% of those seen at the clinic. Black individuals were also more likely to have more advanced dementia at their first visit.

About 40% of Black people and 31% of white people had mild dementia or worse. About 16% of Black people and 10% of white people had moderate or severe dementia.

“Our results are concerning, especially since these clinics are likely to be a major point of access for new Alzheimer's treatments as they become available,” said study author Albert Lai, an associate professor of medicine at Washington University School of Medicine in St. Louis.

“While we studied one memory clinic, if additional research finds similar disparities in other memory clinics, then these differences in access could worsen existing health care disparities," he said in a journal news release.

After adjusting for age, sex and the area deprivation index, researchers found that Black people were 59% more likely to have moderate to severe dementia at their initial evaluation compared to white people.

“This study provides additional motivation for addressing disparities that are likely to affect patient care,” Lai said. “Initiatives may include increased outreach to less affluent and more diverse neighborhoods, reducing requirements for scheduling an initial appointment, and hiring more doctors from diverse backgrounds.”

Research studies often recruit participants from large clinics, Lai noted. Reduced use of these clinics by underserved groups could hamper efforts to make research studies more inclusive, he said.

The study was supported by the Cure Alzheimer's Fund.

More information

The U.S. National Institute on Aging has more on dementia.

SOURCE: Neurology, news release, Aug. 2, 2023