Abstract
Objectives
Increasingly, older populations in the United Kingdom and other well-resourced settings
are ethnically diverse. Despite a concern that the prevalence of dementia is expected
to rise, very little is known about the association of ethnicity and dementia among
aging older adults. The current study aimed to compare ethnic group differences in
symptom profile, functioning and pharmacotherapy at dementia diagnosis.
Design
Cross-sectional study of patient characteristics at the point of dementia diagnosis.
Setting and Participants
In total, 12,154 patients aged 65 years or older diagnosed with dementia in Southeast
London between 2007 and 2015.
Methods
Data were extracted from the Clinical Record Interactive Search system, which provides
anonymized access to the electronic health records of a large mental healthcare provider
in Southeast London. Patients from ethnic minority backgrounds were compared with
white British individuals on mental and physical well-being, functional scales and
medications prescribed at dementia diagnosis, as well as subtype of dementia documented
anywhere in the record.
Results
Compared with white British patients, Black African and Black Caribbean patients were
more likely to present with psychotic symptoms and were less likely to have an antidepressant
prescribed; white Irish patients had higher rates of substance/alcohol use and depressive
symptoms were more prevalent in South Asian patients; all ethnic minority groups had
higher odds of polypharmacy; and vascular dementia diagnoses were more common in Black
and Irish ethnic minority groups.
Conclusions and Implications
At dementia diagnosis, there are substantial differences in noncognitive mental health
symptoms and pharmacotherapy across ethnic minority groups and compared with the white
British majority population. Some of these differences might reflect access/treatment
inequalities or implicit unconscious bias related to ethnicity, influencing both.
They need to be taken into consideration to optimize pathways into care and personalize
assessment and management.
Keywords
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Article info
Publication history
Published online: August 02, 2020
Footnotes
CM, GP and RS receive salary support from the National Institute for Health Research (NIHR) Biomedical Research Center at South London and Maudsley NHS Foundation Trust and King's College London, and RS is a NIHR Senior Investigator. JD receives funding from the Health Foundation working together with the Academy of Medical Sciences for a Clinician Scientist Fellowship. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.
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© 2020 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
