Racial and Ethnic Disparities in the Treatment of Dementia Among Medicare Beneficiaries
Open accessAbstract
OBJECTIVES: Numerous studies have documented disparities in health care utilization between non-Hispanic White and minority elders. We investigated differences in anti-dementia medication use between non-Hispanic White and minority community-dwelling Medicare beneficiaries with dementia. METHODS: Using multivariate analysis with generalized estimating equations, we estimated prevalence ratios (PRs) for anti-dementia medication use by race/ethnicity for 1,120 beneficiaries with dementia from years 2001 through 2003 of the Medicare Current Beneficiary Survey. RESULTS: After adjusting for demographics, socioeconomics, health care access and utilization, comorbidities, and service year, we found that anti-dementia medication use was approximately 30% higher among non-Hispanic Whites compared to other racial/ethnic groups (PR=0.73, 95% confidence interval [CI]=0.59, 0.91). As for individual racial/ethnic groups, prevalence disparities remained significant for non-Hispanic Blacks (PR=0.75, 95% CI=0.57, 0.99) and non-Hispanic others (PR=0.50, 95% CI=0.26, 0.96) but were attenuated for Hispanics (PR=0.84, 95% CI=0.59, 1.20). DISCUSSION: Results provide evidence that racial/ethnic disparities in utilization of drugs used to treat dementia exist and are not accounted for by differences in demographic, economic, health status, or health utilization factors. Findings provide a foundation for further research that should use larger numbers of minority patients and consider dementia type and severity, access to specialty dementia care, and cultural factors.
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Racial ethnic minority group members do not receive equivalent treatment for dementia despite their receipt of Medicare, even when socioeconomic status, health care access and utilization, and comorbidities are considered.
“Racial ethnic minority group members do not receive equivalent treatment for dementia despite their receipt of Medicare, even when socioeconomic status, health care access and utilization, and comorbidities are considered (Zuckerman et al., 2008).”
From Critical Perspectives on Successful Aging: Does It “Appeal More Than It Illuminates”? (2015) · cites this paper as Zuckerman et al., 2008
The Discussion reports approximately 30% lower anti-dementia medication use among community-dwelling minority Medicare beneficiaries with dementia, persisting after adjustment for economic, health-status, health-care-access, and utilization factors. The claim is broader than the finding: the paper measures medication use, not all dementia treatment, and its sample is limited to community-dwelling beneficiaries in 2001–2003. (LLM, conf=0.85)
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References 19 · Cited by 102
Research works printed but not linked: 17
- Briesacher B Limcangco R Gaskin D Racial and ethnic disparities in prescription coverage and medication use Health Care Financing Review 2003 25 2 63 76 15124378 PMC4194807
- Clark PC Kutner NG Goldstein FC Peterson-Hazen S Garner V Zhang R Impediments to timely diagnosis of Alzheimer’s disease in African Americans Journal of the American Geriatrics Society 2005 53 2012 2017 16274388
- Deddens JA Petersen MR Lei X Estimation of prevalence ratios when PROC GENMOD does not converge Paper presented at the Seattle SAS Users Group International Proceedings Seattle, WA 2003, March/April
- Fitzmaurice GM Laird NM Ware JH Applied longitudinal analysis 2004 Wiley-Interscience Hoboken, NJ
- Gruber-Baldini AL Stuart B Zuckerman IH Simoni-Wastila L Miller R Treatment of dementia in community-dwelling and institutionalized Medicare beneficiaries Journal of the American Geriatrics Society 2007 55 1508 1516 17727648
- Hanley JA Negassa A Edwardes MD Forrester JE Statistical analysis of correlated data using generalized estimating equations: an orientation American Journal of Epidemiology 2003 157 4 364 375 12578807
- Leo RJ Narayan DA Sherry C Michalek C Pollock D Geropsychiatric consultation for African-American and Caucasian patients General Hospital Psychiatry 1997 19 3 216 222 9218990
- Manly JJ Espino DV Cultural influences on dementia recognition and management Clinics in Geriatric Medicine 2004 20 1 93 119 15062490
- Mehta KM Yin M Resendez C Yaffe K Ethnic differences in acetylcholinesterase inhibitor use for Alzheimer disease Neurology 2005 65 1 159 162 16009909 PMC2830864
- Rothman KJ Greenland S Modern epidemiology 1998 Lippincott-Raven Philadelphia
- Smedley BD Stith AY Nelson AR Unequal treatment: Confronting racial and ethnic disparities in health care 2003 National Academy Press Washington, DC 25032386
- Smith DB Feng Z Fennell ML Zinn JS Mor V Separate and unequal: racial segregation and disparities in quality across U.S. nursing homes Health Affairs 2007 26 1448 1458 17848457
- Stevens A Owen J Roth D Clay O Bartolucci A Haley W Predictors of time to nursing home placement in White and African American individuals with dementia Journal of Aging and Health 2004 16 375 397 15155068
- Thorpe JM Sleath BL Thorpe CT Van Houtven CH Blalock SJ Landerman LR Caregiver psychological distress as a barrier to influenza vaccination among community-dwelling elderly with dementia Medical Care 2006 44 713 721 16862032
- Williams DR Earl TR Commentary: Race and mental health—More questions than answers International Journal of Epidemiology 2007 36 758 760 17566003
- Wimo A Winblad B Jonsson L An estimate of the total worldwide societal costs of dementia Alzheimers & Dementia 2007 3 2 81 91 19595921
- Yaffe K Fox P Newcomer R Sands L Lindquist K Dane K Patient and caregiver characteristics and nursing home placement in patients with dementia Journal of the American Medical Association 2002 287 2090 2097 11966383
- Authors
- Zuckerman, I. H., Ryder, P. T., Simoni-Wastila, L., Shaffer, T., Sato, M., Zhao, L., & Stuart, B.
- Affiliations
- University of Maryland, Baltimore (US)
- Corresponding author
- Zuckerman, I. H.
- Venue
- The Journals of Gerontology Series B: Psychological Sciences and Social Sciences
- Publisher
- Oxford University Press (OUP)
- Published
- 2008-09-01
- Volume
- 63
- Issue
- 5
- Pages
- S328-S333
- ISSN
- 1079-5014 (ISSN-L)
- 1758-5368
- PMC
- PMC3781927
- OpenAlex
- W1985589912
- Cited by
- 102
- References
- 19
- Citations by year
- 2025: 7 · 2024: 9 · 2023: 10 · 2022: 11 · 2021: 12 · 2020: 6 · 2019: 3 · 2018: 5 · 2017: 5 · 2016: 5 · 2015: 3 · 2014: 3 · 2013: 6 · 2012: 5
- FWCI
- 2.58
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journals of Gerontology Series B (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Digital Commons @ Butler University (Butler University) (submittedVersion)
- Funders
- Commonwealth Fund
- AcademyHealth
- National Institutes of Health (5k01ag022011-05)
- U.S. Food and Drug Administration
- National Institute on Aging (K01 AG22011, K01-AG-022011, T32AG000262)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Social Sciences › Health › Health disparities and outcomes
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- racial and ethnic disparities, dementia, Medicare beneficiaries, minority elders, non-Hispanic blacks, Hispanic Americans, community-dwelling older adults, health care utilization
- MeSH terms
- Aged, Black or African American, Cholinesterase Inhibitors, Dementia, Drug Utilization, Female, Medicare, Hispanic or Latino, Humans, Male, Memantine, Minority Groups, United States, Dopamine Agents, Multivariate Analysis, Nootropic Agents, White People, Health Status Disparities
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