The diagnostic category is "Alzheimer's Disease and Related Dementias" (ADRD). A new study conducted by researchers at the University of Michigan and Dartmouth University proposes that as many as 60% of people struggle with the early stages of dementia are undiagnosed, and that the lack of diagnosis is due to demographic factors, stigma and the skill of clinicians. Where one lives plays a big role in whether you can get an accurate diagnosis.(1)
As with any other disease, early diagnosis matters. It means development of a treatment plan and use of medications that can delay the onset of the disease. That in turn can make a major difference in quality of life and in costs required for treatment.
In the work to date (it's continuing), the research team developed measures for the expected number of diagnoses and compared to actual diagnoses. The data were broken out by demographic and geographic factors.
Blacks and Hispanics have lower levels of diagnosis than do other Americans. There are no know physiological factors to account for that difference.
Persons living in the rural areas, the upper Midwest and the Mountain states tend to have lower levels of diagnosis. Again, there's nothing in physiology or genetics to explain that.
Diagnosis "intensity" is the ratio of the number of positive diagnoses in an area to the number of expected cases. The gray areas in the chart below indicate that diagnoses match expectations. Red shades indicate higher concentrations than expected; the blues are lower.
The pattern is difficulty to explain without looking at healthcare access and quality of care. For example, in Tennessee, the Eastern part of the state through Nashville has a higher than expected rate of diagnosis while Memphis is low. All of Alabama is on the higher side, while most of neighboring Mississippi is low. In Las Vegas, the rate of expected cases and diagnoses is high in the City, while the surrounding Clark and adjacent counties are on target, and Tahoe, Reno and Phoenix are very low.
Demographic (e. g., sex and race) and behavioral factors (e. g., obesity and smoking) only explain about 33% of the variation in the intensity of diagnoses. For that reason, we need to consider other explanations for the variation in diagnosis. The authors offer the following:
The implication of these results for individuals is that care in some health systems or areas may be more inclined toward recognition and diagnosis of ADRD. And the differences across place are greatest for younger, Black, or Hispanic older adults.(2)
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