Black Americans are twice as likely to develop Alzheimer’s and other dementias as white Americans. The reason why isn’t clear, though only 20% of Black Americans report having no barriers to excellent health care and support for dementia. A new study has identified another disparity.
A preliminary study, set to be presented at the American Academy of Neurology’s annual meeting next month, investigated the link between race and dementia medications. It found that Black patients received five different types of meds substantially less often than white patients.
Dr. Alice Hawkins, the study’s first author and member of the American Academy of Neurology, says, “Previous research has shown that due to racial disparities, people with dementia do not always receive the same access to medications that may be beneficial in nursing homes and hospitals. However, there is limited data for the use of dementia medications that people take at home. Our study found disparities in this area as well. We hope our findings lead to a better understanding of these disparities so that steps can be taken to eliminate this health inequity.”
The team conducted their research with data from nearly 26,000 people, including 3,655 Black participants and 12,885 white participants. They were asked about race and their outpatient medications. The five medications studied in this research were cholinesterase inhibitors, which help prevent the breakdown of a chemical messenger linked with memory and thought; N-methyl-D-aspartate (NMDA) antagonists, which can help with cognitive function; common antidepressants selective serotonin reuptake inhibitors, or SSRIs; benzodiazepines, which treat anxiety and agitation; and antipsychotics.
The researchers found that for all five, Black patients received fewer medications than white patients. While 30% of white patients had received cholinesterase inhibitors, only 20% of Black patients had. NMDA antagonists were given to 17% of white patients and only 10% of Black patients. Forty percent of white patients had received SSRIs, compared to 24% of Black patients, while the figures were 37% to 18% for benzodiazepines and 22% to 18% for antipsychotics. The researchers say these disparities remained even after controlling for confounding factors, including insurance type.
There was one factor that seemed to lead to a bit more equity, though.
Dr. Hawkins explains, “Black people who saw a neurologist were receiving cholinesterase inhibitors and NMDA antagonists at rates more comparable to white people. Therefore, referrals to specialists such as neurologists may decrease the disparities for these prescriptions.”
The team acknowledged a few limitations of their study, including that data was drawn from what was listed in medical records, and that there was no reliable way to collect data on prescription behavior of doctors, so it’s unclear how much of the difference was due to fewer medications being prescribed. As a result, the team says more research is needed to better understand the causes of these disparities.