• Posted November 14, 2024

Many Cases of Dementia Go Undiagnosed in Poorer Communities

Dementia strikes all races, but new research suggests thinking declines in poor seniors are often overlooked.

Among a group of more than 200 low-income patients who were treated at community health centers, 3 of 4 had undiagnosed cognitive issues, researchers reported recently in the journal JAMA Network Open.

Of those, 62% had mild cognitive impairment, which is a precursor to dementia, while 12% had full-blown undiagnosed dementia, results showed.

Only 25% of the patients evaluated had no evidence of any cognitive decline, researchers found.

“Unrecognized cognitive impairment and dementia present a serious challenge in the U.S. and worldwide, affecting patients, families and the health care system,” said lead researcher Dr. Ambar Kulshreshtha, an associate professor of family and preventive medicine at Emory University School of Medicine in Atlanta.

“Delayed diagnosis often means patients are identified at later stages, when symptoms are more severe and care is more complex,” Kulshreshtha added in an Emory news release. “It also leads to missed opportunities for early treatment that could slow disease progression.”

For the study, researchers looked at seniors treated at federally qualified health centers, which are nonprofits serving low-income communities in the United States.

About 30 million people receive care at these centers, and most have family incomes below 200% of the federal poverty level.

Researchers assessed a group of 204 seniors who go to one of five such centers in Indianapolis, to determine whether they were showing any signs of brain aging. 

It turned out that about 75% of the seniors had undiagnosed cognitive issues related to aging, researchers found.

The results also revealed significant racial disparities, researchers said.

Black patients were more than twice as likely as whites to have undiagnosed mild cognitive impairment or dementia, researchers found.

“Our findings underscore the need for timely screening among older adults, especially high-risk groups like African Americans,” Kulshreshtha said. “Other minority groups, like non-English speaking individuals and those in rural areas, may face even greater challenges in accessing cognitive screenings.”

Many patients don’t have access to a specialist in brain health. For those patients, experts recommend incorporating brief cognitive tests during routine visits as a practical solution for early detection.

“There’s still stigma and misconceptions about dementia, and we need to do more to educate our communities,” Kulshreshtha said. “With new treatment options and lifestyle changes that can help, health care systems must evolve to provide timely, equitable approaches for early detection and intervention.”

More information

The National Institute on Aging has more about memory problems, forgetfulness and aging.

SOURCE: Emory University, news release, Nov. 12, 2024