Location, location, location!
Where you live in the US may affect your chances of getting a dementia diagnosis, a new study from the University of Michigan and Dartmouth College finds.
Nearly 7 million Americans have been diagnosed with dementia, the researchers said, while millions more likely have symptoms but have not been formally diagnosed.
The study authors found a person has up to twice the chance of getting a dementia diagnosis in some regions than in others. For example, someone in Wichita Falls, Texas, may be twice as likely to get diagnosed than if he was in Minot, N.D.
“Even within a group of people who are all 80, depending on where you live, you might be twice as likely to actually get a diagnosis,” Julie Bynum, the study’s lead author and a geriatrician at the University of Michigan Medical School, told NPR.
The research, published last week in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, found the variation was most striking for Black and Hispanic people and those on the younger end of the risk range, between 66 and 74 years old.
Utilizing Medicare and demographics data, researchers created two maps. The first shows the percentage of people in each region who received a formal diagnosis. The second map estimates what that percentage should be based on age, race, level of education, obesity and other dementia risk factors.
The differences between the two were profound, with portions of the Great Plains and Southwest seeing less diagnosis than expected.
“We tell anecdotes about how hard it is to get a diagnosis and maybe it is harder in some places,” Bynum explained to NPR. “It’s not just your imagination. It actually is different from place to place.”
The most common form of dementia, Alzheimer’s disease, is a debilitating, progressive neurological condition that leads to a decline in memory, lack of mobility and other complications.
Some lifestyle factors that may raise the risk of developing Alzheimer’s disease include tobacco and alcohol use, sleep quality, high blood pressure, social isolation, high cholesterol and inactivity.
This study suggests that the likelihood of diagnosis is related more to access to health care and language and cultural barriers than individual risk factors.
Diagnosing dementia can be a complicated process because there isn’t a single test that reveals you have dementia. A doctor may use cognitive assessments, brain scans and psychiatric evaluations to make a diagnosis.
A formal diagnosis is crucial for access to and insurance coverage of the latest biomarker tests, brain imaging scans and dementia-slowing medications.
The US Food and Drug Administration recently approved Kisunla and Leqembi to treat early-stage Alzheimer’s disease.
Even in dementia cases where treatment is not an option, a diagnosis can support a patient’s plan for care.
Bynum hopes the results of this study spur change.
“For communities and health systems, this should be a call to action for spreading knowledge and increasing efforts to make services available to people,” she said. “And for individuals, the message is that you may need to advocate for yourself to get what you need, including cognitive checks.”
