Ethnic inequalities in access to dementia diagnosis and good quality care in the United Kingdom
This grant was awarded to Prof Claudia Cooper, University College London, in 2016 to investigate whether there are inequalities by ethnicity in (a) the rates of dementia diagnosis; (b) psychotropic drug prescribing and (c) healthcare service use in White, Black and Asian ethnic groups among people with dementia in the UK. This is the first study done in the UK comparing the incidence of dementia diagnosis by ethnicity in a nationally representative sample. The team analysed data on more than 2.5 million people, including 66,083 with dementia, from 645 GP practices across the UK between 2007 and 2015.
The results of the study show that rates of dementia diagnosis in the UK are higher among Black ethnic groups than they are for White and Asian groups. In more detail, incidence of dementia diagnosis was:
- 25% higher in Black women than White women
- 28% higher in Black men than White men
- 18% lower in Asian women than White women
- 12% lower in Asian men than White men
More research is needed to elucidate the reasons for the higher incidence of dementia in certain ethnic groups. Previous research has shown that factors which affect dementia risk, such as level of formal education, financial deprivation, smoking, physical activity, mental health and some mid-life health outcomes, differ between ethnic groups.
The research team also estimated that Black man developing dementia were 11% less likely than their white counterparts to receive a diagnosis and that among people with dementia, Asian people were less likely to be prescribed anti-dementia drugs compared to White ethnic groups. There was no consistent evidence found for ethnic inequalities in physical healthcare, though people from all ethnic groups were not receiving physical health preventative care as frequently as advised by guidelines.
Prof Claudia Cooper, from UCL Division of Psychiatry, observed:“Our new findings may reflect, for example, that there are inequalities in the care people receive to prevent and treat illnesses associated with dementia. Or perhaps GPs or patients’ families are reluctant to name dementia in communities where more stigma is associated with a dementia diagnosis.”
Wesley Dowridge, member of King’s College London’s Social Care Workforce Research Unit Service User and Carer Advisory Group, and study steering group member, added: “As a Black carer and one of the Windrush generation, these findings make me think about why Black people I know have been reluctant to seek help for memory problems: worries about being treated fairly, or being put in a care home. This study shows how important it is that messages about the benefits of timely dementia diagnoses reach everyone, especially people from minority ethnic groups.”
Co-investigators on this grant are: Professor Irene Peterson, Dr Kate Walters, Dr Naaheed Mukadam, Professor Jill Manthorpe and Professor Rosalind Raine. The research associate on this grant is Dr Tra My Pham.