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Dementia diagnosis rates and the impact of ethnicity, rurality and deprivation

Hazan, J; Liu, KY; Isaacs, JD; Mukadam, N (2024) Dementia diagnosis rates and the impact of ethnicity, rurality and deprivation. AGING & MENTAL HEALTH. ISSN 1360-7863 https://doi.org/10.1080/13607863.2024.2374936
SGUL Authors: Isaacs, Jeremy

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Abstract

Objectives NHS England publishes monthly national and regional estimated dementia diagnosis rates (DDR) to assess the healthcare system’s effectiveness in identifying dementia cases. Previous research indicates that sociodemographic factors, such as ethnic minority status, socioeconomic deprivation, and rurality, influence both healthcare quality and dementia risk. This study aimed to examine the association between these sociodemographic factors and DDR, and to estimate an ethnicity-adjusted DDR using available ethnic group data. Method We analysed NHS Digital Primary Care Dementia Data electronic health records for July 2023. We used a linear regression model to determine the association between DDR and ethnicity, deprivation, and rurality factors using local authority region level data. We also adjusted the DDR at the level of sub-integrated care boards based on previously published odds ratios of dementia diagnosis by ethnic group. Results Regression modelling revealed that areas with higher proportions of minority ethnic groups and greater rurality had lower DDRs. Conversely, higher levels of deprivation were linked to higher DDRs. After adjusting for different odds ratios for dementia in minority ethnic groups, the national DDR decreased by 1%, with regional diagnosis rates dropping by up to 5.4%. Conclusion Higher regional proportional ethnic minority population and greater rurality were associated with a lower DDR which might reflect poorer access to diagnostic services. Higher deprivation levels were associated with a higher DDR which might reflect higher rates of dementia in more deprived populations. We discuss measures to improve the accuracy and utility of the DDR, with a specific focus on ethnicity.

Item Type: Article
Additional Information: © 2024 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The terms on which this article has been published allow the posting of the Accepted Manuscript in a repository by the author(s) or with their consent.
Keywords: Dementia, diagnosis, ethnicity, deprivation, rurality, 11 Medical and Health Sciences, 16 Studies in Human Society, 17 Psychology and Cognitive Sciences, Geriatrics
Journal or Publication Title: AGING & MENTAL HEALTH
ISSN: 1360-7863
Dates:
DateEvent
16 October 2024Published
19 June 2024Accepted
Publisher License: Creative Commons: Attribution 4.0
Projects:
Project IDFunderFunder ID
MR/S021418/1Medical Research Councilhttp://dx.doi.org/10.13039/501100000265
AS-SF-18b-001Alzheimer's Societyhttp://dx.doi.org/10.13039/501100000320
Web of Science ID: WOS:001332889500001
URI: https://openaccess.sgul.ac.uk/id/eprint/116902
Publisher's version: https://doi.org/10.1080/13607863.2024.2374936

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