Patterns and Disparities in Formal Dementia Diagnosis and Awareness of Diagnosis
Year: 2017
Type: article
Abstract: Despite increasing prevalence, about half of older adults with dementia are undiagnosed. Both formal diagnosis and patient/family awareness of the diagnosis may have implications for medical care, decision-making, and future planning. We linked data from the National Health and Aging Trends Study (NHATS), a nationally representative sample of Medicare beneficiaries in the United States, to Medicare claims to examine formal diagnosis (claims-based diagnosis), awareness of dementia (self-reported physician diagnosis), and sociodemographic differences between dementia status groups. Among 7,609 community-dwelling older adults in NHATS, 13.6% (n=1,038) met validated NHATS criteria for probable dementia. We analyzed 633 individuals with probable dementia who had 3 years of continuous fee-for-service coverage in four groups. 116 participants (18.3%) did not report a physician diagnosis but had a claims diagnosis of dementia (unaware but diagnosed); 240 (37.9%) reported a physician diagnosis and had a claims diagnosis (aware and diagnosed); 229 (36.2%) neither reported a diagnosis nor had a claims diagnosis (unaware and undiagnosed); and 48 (7.6%) reported a diagnosis but lacked claims diagnosis (aware but undiagnosed). Females and older participants were more likely to be formally diagnosed, irrespective of awareness of diagnosis. Proportions of non-whites and less than high school educated were greatest in the unaware and undiagnosed group. Median income was greatest in those who were aware and diagnosed (p < 0.05 for all between group differences except education, for which p=0.08). Understanding both formal diagnosis and awareness of the diagnosis may be important to reduce disparities and improve care in dementia.
Source: Innovation in Aging
Authors: H. Amjad, A. Ahuja, J.L. Wolff, C.G. Lyketsos, Q. Samus, D.L. Roth
Institution: Johns Hopkins University
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,977
OpenAlex ID: W2727458423