Diagnosing dementia is a complex and prolonged journey for many, with individuals from specific racial or ethnic backgrounds and those residing in non-urban areas encountering extra hurdles, reveals a research initiative spearheaded by scholars at Washington State University.
This investigation, which scrutinized the data of almost 95,000 inhabitants of Washington state, discovered that those situated in remote locales, alongside Native American and Hispanic populations, are required to travel greater distances to consult neurology experts. The disparity in access, as pointed out by the researchers, likely leads to diagnosis delays. Such postponements can escalate the costs associated with care, diminish the potential for maintaining cognitive abilities, and adversely affect the quality of life for those living with dementia.
Solmaz Amiri, the principal investigator of the study and a member of the WSU Elson S. Floyd College of Medicine and the Institute for Research and Education to Advance Community Health (IREACH), emphasized the growing necessity for medical professionals adept at addressing the needs of individuals with Alzheimer’s disease and related conditions, particularly as diagnoses increase. Highlighting the additional challenges faced by rural and minority groups in accessing care, Amiri underscored the importance of comprehending these barriers to facilitate improved dementia care outcomes.
The research, published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, analyzed death records from 2011–2021 in Washington state, identifying individuals with Alzheimer’s or similar dementias. The study revealed significant differences in the proximity to neurologists, with urban dwellers living an average of 9 miles away, compared to much longer distances for those in suburban, small-town, and rural areas. Additionally, it was found that Native American and Hispanic individuals had to travel considerably farther to see a neurologist compared to other racial groups.
Amiri noted the increasing need for dementia patients to access neurologists as the condition progresses, highlighting how even seemingly short distances can pose significant obstacles. The findings of this research could guide the strategic placement of medical resources, including neurology practices and educational programs for medical students, to mitigate disparities in dementia care.
Proposed solutions to address these gaps include leveraging telemedicine and mobile health services for rural populations and enhancing the training of rural primary care doctors in dementia care. That comes against a backdrop where most primary care physicians, despite often providing dementia care, report inadequate training in this domain.
The study also acknowledged that barriers to care access were not examined due to data limitations, such as insurance coverage issues and appointment wait times. It highlighted cultural factors that may deter certain racial groups from seeking care, particularly among Black individuals, who, despite living closer to neurologists, face significant disparities in dementia diagnosis and outcomes, potentially due to historical mistrust in the healthcare system.
Looking forward, the researchers aim to deepen their understanding of how various factors, including access to physicians and community characteristics, impact dementia outcomes. They plan to conduct further studies focusing on these aspects.
More information: Solmaz Amiri et al, Racial, ethnic, and rural disparities in distance to physicians among decedents with Alzheimer’s disease and related dementias in Washington State, Alzheimer s & Dementia. DOI: 10.1002/alz.13756
Journal information: Alzheimer s & Dementia Provided by Washington State University
