March 10, 2023 – Black people who are diagnosed with dementia are significantly less likely than white people to be prescribed medications for the disease, according to a new study.
Among five types of medications commonly used to treat dementia, the prescribing rate was as much as 19 percentage points lower for Black people than white people.
“Previous research has shown that due to racial disparities, people with dementia do not always receive the same access to medications that may be beneficial in nursing homes and hospitals,” said Alice Hawkins, MD, a neurologist at Mount Sinai in New York, in a statement. “However, there is limited data for the use of dementia medications that people take at home. Our study found disparities in this area as well. We hope our findings lead to a better understanding of these disparities so that steps can be taken to eliminate this health inequity.”
The findings, presented recently at the annual meeting of the American Academy of Neurology, examined the prescribing rates for dementia medications among 25,930 people who received medical care at Mount Sinai, which is a health care system in New York. All the patients in the study had been diagnosed with dementia.
Dementia is characterized by changes in mental skills, such as memory and planning, that are so severe that they impact a person’s daily life, according to Stanford Medicine. There is no cure for dementia, but medications may slow its progress, improve mental function, or improve mood and anxiety problems that often accompany dementia.
In the study, researchers found that the prescribing rates for five types of dementia medications were lower for Black people than for white people as follows:
- For cholinesterase inhibitors, which help memory and thought functions, the rate was 10 percentage points lower;
- For NMDA antagonists, which help cognitive function, the rate was 7 percentage points lower;
- For SSRIs, which are antidepressants, the rate was 16 percentage points lower;
- For antipsychotics, which treat psychosis and disconnection from reality, the rate was 4 percentage points lower;
- For benzodiazepines, which treat anxiety and agitation, the rate was 19 percentage points lower.
The differences persisted after people’s age, sex, and insurance type were incorporated into the analysis.
Researchers found that Black patients were more likely than white patients to be referred to see a specialist. When Black people saw a neurologist, they were prescribed two types of medications at similar rates to white people. Those two types were cholinesterase inhibitors and NMDA antagonists. The researchers wrote that more referrals to specialists such as neurologists may help decrease prescribing differences.
“This study has exposed so many more areas of inquiry and raises more questions than I think it answers,” Hawkins told BuzzFeed News. “We need to start diving into the factors that contribute to those disparities and make sure that all of the elements of comprehensive dementia care are being met for patients, no matter their racial or ethnic background.”