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

ABSTRACT: 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.

SUBMITTER: Gianattasio KZ 

PROVIDER: S-EPMC6926355 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature