Racial disparities and temporal trends in dementia misdiagnosis risk in the United States.

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Tytuł:: Racial disparities and temporal trends in dementia misdiagnosis risk in the United States.
Autorzy:: Gianattasio KZ; Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
Prather C; Department of Medicine, School of Medicine and Health Sciences, George Washington University, Washington, DC, USA.
Glymour MM; Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA.
Ciarleglio A; Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
Power MC; Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
Źródło:: Alzheimer's & dementia (New York, N. Y.) [Alzheimers Dement (N Y)] 2019 Dec 09; Vol. 5, pp. 891-898. Date of Electronic Publication: 2019 Dec 09 (Print Publication: 2019).
Typ publikacji:: Journal Article
Język:: English
Imprint Name(s):: Publication: 2020- : [Hoboken, NJ] : Wiley on behalf of the Alzheimer's Association
Original Publication: [New York, NY] : Elsevier Inc., [2015]-
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Grant Information:: R03 AG055485 United States AG NIA NIH HHS; U01 AG009740 United States AG NIA NIH HHS
Contributed Indexing:: Keywords: Alzheimer's disease; Clinical diagnosis; Dementia; Disparities; Health and retirement study
Entry Date(s):: Date Created: 20200101 Latest Revision: 20220412
Update Code:: 20240104
PubMed Central ID:: PMC6926355
DOI:: 10.1016/j.trci.2019.11.008
PMID:: 31890853
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Introduction: Systematic disparities in misdiagnosis of dementia across racial/ethnic groups have implications for health disparities. We compared the risk of dementia under- and overdiagnosis in clinical settings across racial/ethnic groups from 2000 to 2010.
Methods: We linked fee-for-service Medicare claims to participants aged ≥70 from the nationally representative Health and Retirement Study. We classified dementia status using an algorithm with similar sensitivity and specificity across racial/ethnic groups and assigned clinical dementia diagnosis status using ICD-9-CM codes from Medicare claims. Multinomial logit models were used to estimate relative risks of clinical under- and overdiagnosis between groups and over time.
Results: Non-Hispanic blacks had roughly double the risk of underdiagnosis as non-Hispanic whites. While primary analyses suggested a shrinking disparity over time, this was not robust to sensitivity analyses or adjustment for covariates. Risk of overdiagnosis increased over time in both groups.
Discussion: Our results suggest that efforts to reduce racial disparities in underdiagnosis are warranted.
(© 2019 The Authors.)

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