Ethnic disparities in the uptake of anti‐dementia medication in young and late onset dementia

Abstract

AbstractBackgroundPeople with dementia (PwD) can face barriers when trying to access care after a diagnosis, particularly in young‐onset dementia (YOD). Little is known however about the effects of ethnicity on access to anti‐dementia medication and how these differ between age groups. The aim of this study was to analyse national data on variations in the current uptake of anti‐dementia medication between people with YOD and late‐onset dementia (LOD).MethodData from the US National Alzheimer’s Coordinating Centre was obtained from September 2005 to March 2019. First visits of people with a diagnosis of Alzheimer’s disease (AD) dementia, Lewy Body dementia (LBD), and Parkinson’s disease dementia (PDD) were included. Logistic regression was used to analyse the effects of education and ethnicity on use of cholinesterase inhibitors and memantine, accounting for YOD/LOD, gender, living situation, severity stage, and comorbidities.ResultIn total, 15,742 people with AD dementia and LBD/PDD were included, with 11,019 PwD having completed a first follow‐up visit. Significantly more people with YOD used memantine than those with LOD, whilst fewer used cholinesterase inhibitors. PwD from minority ethnic backgrounds used memantine and cholinesterase inhibitors less often than those from a White ethnic background. Logistic regression analysis showed that ethnicity was a significant determinant of both memantine and cholinesterase inhibitors usage, while education was only a significant determinant for memantine usage.ConclusionFindings highlight the impact of social factors on current usage of anti‐dementia medication, and highlight the need for more resources to enable equitable access to anti‐dementia medication.