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Vivian Xie
14 May 2024

Racial disparities in diagnosis and drug use for dementia symptoms

A study from the USC Schaeffer Center for Health Policy & Economics has revealed the existence of racial disparities in the US for the diagnosis of dementia and the use of drug treatments for symptoms. 

Published in the Journal of Alzheimer’s Disease, the study found that, when compared to Black and Asian patients, white and Hispanic individuals with Alzheimer’s disease and/or related dementia disorders were more likely to be prescribed central nervous system (CNS) active drugs.

These include antidepressants, antipsychotics, and anticonvulsants, even though such drugs have been associated with cardiovascular events, hospitalisation, and on occasion, death. The majority of those exhibiting behavioural and psychological symptoms of dementia used a CNS drug, largely antidepressants. Even so, 67.6% of Hispanic individuals and 66% of white individuals were prescribed CNS drugs compared with 58.6% of Black patients and 54.5% of Asian patients. The study examined data from Medicare claims for those diagnosed with dementia from 2017 to 2019. This timeframe was taken before the onset of the COVID-19 pandemic, when the pandemic disrupted the US healthcare system.  

Study lead author Johanna A Thunell, research scientist at USC Schaeffer Center, commented “The open question remains: are there actually higher rates of, say, depression among white people with dementia? Or are there cultural or other barriers that are keeping Black and Asian people with dementia from getting a diagnosis and potential treatment?” 

Substantial differences in the type of drugs prescribed for different ethnic groups were revealed. Geoffry Joyce, director of Health Policy at the USC Schaeffer Center, stated “We also found substantial differences in who was taking individual drugs classes. For example, while white people were most likely to take antidepressants, American Indian and Alaska Natives had the highest rates of opioid prescriptions.” Opioids are highly addictive and have been at the centre of a continuing health crisis in the US.  

Non-white people were also suggested to be underdiagnosed for treatable symptoms of dementia. A previous study by the USC Schaeffer Center found that Black and Hispanic patients more likely to have a late diagnosis or none at all. Such racial and ethnic differences in dementia diagnosis and care can have devastating impacts on the prognosis for these patients.  

“We’re finding high levels of diagnoses of behavioural symptoms and use of drugs among these groups who are potentially vulnerable to these types of negative side effects,” commented Thunell. “There are certainly benefits to getting a diagnosis so that you can get some form of treatment – even if it’s non-pharmacological – and we aren’t seeing as high of rates of diagnoses in non-white people. This could present challenges for persons with dementia and their caregivers.” 


USC study reveals racial disparities in diagnosis and drug use for dementia symptoms [Accessed May 14, 2024]  

Vivian Xie
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