A new generation of Alzheimer’s treatments is offering fresh hope to people living with the disease. Still, a troubling question is emerging: Who actually gets access to these potentially life-changing medications? A new study suggests that race, ethnicity, health conditions and socioeconomic circumstances may play a significant role in determining who receives treatment, raising concerns that medical advances could widen existing healthcare inequalities rather than benefit everyone equally.

Researchers at Michigan Medicine found striking racial and ethnic differences in access to anti-amyloid medications, a new class of drugs designed to slow cognitive decline by targeting amyloid plaques in the brain. Black adults had 86% lower odds of receiving these treatments than non-Hispanic white adults, while Hispanic adults had 79% lower odds. The findings, published in Neurology, the medical journal of the American Academy of Neurology, highlight potential barriers to accessing Alzheimer’s therapies as their use becomes more widespread.

“The association we found between race/ethnicity and anti-amyloid medication use raises important questions about how patients are identified, evaluated and ultimately selected for treatment,” said Dr. Melissa Elafros, co-first author of the study and a research professor at the University of Michigan Medical School. She emphasised the importance of understanding and addressing these differences early, ensuring that advances in Alzheimer’s treatment reach as many eligible patients as possible.

To investigate who receives these medications, researchers examined a database containing information on more than one million adults diagnosed with mild cognitive impairment or dementia. They identified 2,427 patients who had received anti-amyloid treatment and compared them with a similar group who had not. The analysis revealed that race, ethnicity and coexisting health conditions were strongly associated with treatment access. Social and economic circumstances also appeared to matter considerably. Patients experiencing greater disadvantages, including lower income, limited educational opportunities and fewer neighbourhood or housing resources, were nearly half as likely to receive the newer medications.

However, the researchers uncovered an important distinction between gaining access to treatment and continuing it once prescribed. Among patients who began taking anti-amyloid medications, initial adherence was similar across racial and ethnic groups. In other words, although some populations were substantially less likely to receive treatment in the first place, those who did start therapy were just as likely to follow their prescribed medication regimen, regardless of race or ethnicity.

“Although race, ethnicity and overall vulnerability are associated with whether patients receive an anti-amyloid medication, we found no differences in initial adherence among those who start treatment,” said Dr. Brian Callaghan, senior author of the study and professor at the University of Michigan Medical School. The findings suggest that efforts to reduce inequalities should concentrate on identifying eligible patients, improving access to specialist assessments and helping people begin treatment, rather than assuming that certain groups are less likely to follow medical advice. As Alzheimer’s therapies continue to evolve, ensuring fair access may prove just as important as developing effective treatments.

More information: Evan Lee Reynolds et al, Predictors of Antiamyloid Medication Utilization and Adherence Among People With Alzheimer Disease and Mild Cognitive Impairment, Neurology. DOI: 10.1212/WNL.0000000000218594

Journal information: Neurology Provided by Michigan Medicine – University of Michigan