Mapping racial and ethnic healthcare disparities for persons living with dementia: A scoping review

Abstract

Introduction: We set out to map evidence of disparities in Alzheimer's disease and Alzheimer's disease related dementias healthcare, including issues of access, quality, and outcomes for racial/ethnic minoritized persons living with dementia (PLWD) and family caregivers.

Methods: We conducted a scoping review of the literature published from 2000 to 2022 in PubMed, PsycINFO, and CINAHL. The inclusion criteria were: (1) focused on PLWD and/or family caregivers, (2) examined disparities or differences in healthcare, (3) were conducted in the United States, (4) compared two or more racial/ethnic groups, and (5) reported quantitative or qualitative findings.

Results: Key findings include accumulating evidence that minoritized populations are less likely to receive an accurate and timely diagnosis, be prescribed anti-dementia medications, and use hospice care, and more likely to have a higher risk of hospitalization and receive more aggressive life-sustaining treatment at the end-of-life.

Discussion: Future studies need to examine underlying processes and develop interventions to reduce disparities while also being more broadly inclusive of diverse populations.

Keywords: dementia; dementia disparities; health equity; healthcare disparities; racial/ethnic disparities.

FIGURE 1

Preferred Reporting Items for Systematic Reviews and Meta‐Analyses flow diagram of the study selection process.

FIGURE 2

Number of articles for each healthcare domain (n = 71). Some studies report findings across multiple healthcare domains.

FIGURE 3

Evidence of racial/ethnic disparities in Alzheimer's disease and Alzheimer's disease related dementias healthcare.