Racial and ethnic disparities in the treatment of dementia among Medicare beneficiaries

J Gerontol B Psychol Sci Soc Sci. 2008 Sep;63(5):S328-33. doi: 10.1093/geronb/63.5.s328.

Abstract

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.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Black or African American / statistics & numerical data
  • Cholinesterase Inhibitors
  • Dementia / drug therapy*
  • Dopamine Agents
  • Drug Utilization
  • Female
  • Health Status Disparities*
  • Hispanic or Latino / statistics & numerical data
  • Humans
  • Male
  • Medicare
  • Memantine
  • Minority Groups*
  • Multivariate Analysis
  • Nootropic Agents*
  • United States
  • White People / statistics & numerical data

Substances

  • Cholinesterase Inhibitors
  • Dopamine Agents
  • Nootropic Agents
  • Memantine