Black Americans Wait Longer for Cognitive Impairment Tests, Raising Risk of Later Dementia Diagnosis

Black Americans are twice as likely as their white counterparts to develop dementia. In fact, currently, about 21% of Black seniors 70 and older are living with the disease. They may face disparities in treatment, though, with research finding that they’re less apt to receive disease-related medications. A new study shows that they may also be getting tested years later than other racial groups in the United States, and be less apt to be screened in the most effective way.

According to data presented at this year’s meeting of the Radiological Society of North America, Black patients with suspected cognitive impairment undergo brain imaging at an average age of nearly five years older than white patients and six years older than Hispanic patients. Additionally, only half of Black patients receive MRI testing, compared with 60% of their white counterparts and 67% of Hispanic patients. This means they might not be getting the most effective testing.

Dr. Joshua Wibecan, the study’s lead author and radiology resident at Boston Medical Center in Boston, Massachusetts, says, “Our study demonstrates two main findings. First, Black patients who received MRI or CT for cognitive impairment were significantly older than patients from other races. Second, Black patients were significantly less likely to be imaged with MRI, the optimal type of imaging for cognitive impairment, as opposed to CT.”

Closeup of senior's hands

The researchers say while both forms of imaging are useful in detecting cognitive impairment, an MRI is more detailed.

To determine how and when patients were tested via these methods, Dr. Wibecan and his team looked at four years of data from their safety net academic medical center, which provides health care for everyone, regardless of health insurance coverage or ability to pay. They looked specifically at outpatient CTs of the head, CT angiographies of the head, and MRI brain scans done for cognitive impairment. They then got the patients’ self-identified race information from the Boston Medical Center Clinical Data Warehouse for Research.

The team found that Black patients underwent brain imaging for cognitive impairment at an average age of 72.5 years, compared with 67.8 for white patients and 66.5 for Hispanic patients.

The researchers say that this could get in the way of early detection of cognitive impairment, which could be caused by something treatable, like tumors or swelling in the brain. With more Alzheimer’s treatments being developed, it may also help stave off the worst of that disease longer.

Dr. Wibecan says, “If disparity in obtaining access to neuroimaging is one possible barrier that delays diagnosis, it is important to identify this and figure out possible solutions to benefit these patients and prevent a delayed diagnosis.”

Senior Black couple gardening

The Alzheimer’s Association says Black dementia patients face a variety of other disparities. Half of Black Americans have said they’ve experienced discrimination while seeking care for someone living with Alzheimer’s, while only 48% say they’re confident they can access culturally competent care. Finally, only 20% report having no barriers to excellent health care and support for Alzheimer’s and other dementias.

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