• Posted August 16, 2024

Likelihood of Dementia Getting Diagnosed Varies Widely Across U.S.

Where you live in the United States could play a role in whether you get a timely diagnosis of dementia, a new study says.

The same person can have twice as much chance of getting a dementia diagnosis in some areas of the country than others, researchers found.

And a timely diagnosis is becoming more and more critical, with research showing that earlier treatment can have a greater impact on a person’s dementia progression, researchers said.

Nearly 7 million Americans currently have a dementia diagnosis, but experts suspect millions more have symptoms but no formal diagnosis.

“The message is clear: from place to place the likelihood of getting your dementia diagnosed varies, and that may happen because of everything from practice norms for health care providers to individual patients’ knowledge and care-seeking behavior,” said lead researcher Julie Bynum, a professor of internal medicine at the University of Michigan Medical School. “But the good news is, these are things we can act on once we know where to look.”

The study focused on “diagnostic intensity” -- the difference in getting a dementia diagnosis between areas after all risk factors and population differences have been stripped away.

For the project, researchers analyzed data on 4.8 million people covered by traditional Medicare and older than 66 in 2019.

Researchers estimated that about 7% of those covered by traditional Medicare -- nearly 357,000 of the people studied -- had a dementia diagnosis at any given time, and about 3% of this population is newly diagnosed each year.

Comparing regions of the United States, they found the prevalence of dementia diagnoses ranged from as low as 4% to as high as 14%. Likewise, the rate of new dementia diagnoses ranged from 1.6% to 5.4%.

These results showed that in the regions of lowest diagnostic intensity, people are 28% less likely to receive a timely diagnosis of dementia, compared to the national average.

Those living where diagnostic intensity is highest are 36% more likely to be diagnosed.

Variations were even more pronounced for seniors ages 66 to 75 and for Black or Hispanic seniors.

The “stroke belt” in the South had the greatest concentration of diagnosed dementia cases, researchers found.

However, diagnostic intensity varied even in the South once researchers adjusted for other factors.

These variations might reflect differences in clinical practices, Bynum said. For example, in some places people might be screened more often by their doctor for early signs of dementia, or have better access to specialists who can confirm a diagnosis.

These variations also might reflect cultural or personal differences. In some locales, people might be reluctant to seek any kind of health care, much less schedule an appointment due to memory concerns or bringing up any memory problems with their doctor, Bynum said.

The new study was published Aug. 16 in the journal Alzheimer’s & Dementia.

Medicare covers a cognitive screening during each enrollee’s wellness visit, Bynum noted.

Areas with lower-than-expected diagnosis rates can use these new findings to figure out what’s getting in the way, Bynum said.

“The goal these days should be to identify people with cognitive issues earlier, yet our data show the younger age group of Medicare participants is the one with the most variation,” Bynum said in a university news release.

“For communities and health systems, this should be a call to action for spreading knowledge and increasing efforts to make services available to people,” Bynum added. “And for individuals, the message is that you may need to advocate for yourself to get what you need, including cognitive checks.”

More information

The National Institute on Aging has more about dementia.

SOURCE: University of Michigan, news release, Aug. 16, 2024