A new study reveals that diagnoses of Alzheimer's and other dementias can differ based on zip code.

A new study suggests that the likelihood of getting a dementia diagnosis may be influenced by your home address.

Nearly five million older adults in regional health care markets across the country were analyzed by researchers from the University of Michigan Medical School, with a focus on areas with higher rates of Alzheimer's disease and other dementia diagnoses.

Residents in areas with a higher rate of diagnosis were twice as likely to discover they had the condition, particularly among those aged 66 to 74 and Black and Hispanic subgroups.

Dr. Julie Bynum, a researcher and professor in the Department of Internal Medicine at University of Michigan Medical School, stated that the number of people who receive a formal diagnosis varies among regions, according to a study she led.

"The percentage of people diagnosed with dementia varies among populations due to factors such as age, race, and cardiovascular risks, but we cannot fully account for these differences based solely on these characteristics."

The availability of clinicians with experience in diagnosing and caring for people with dementia and the accessibility of health care may impact certain health system factors, according to Bynum.

The cities with the highest dementia diagnosis rates are McAllen, Wichita Falls, and Harlingen in Texas; Miami, Florida; Lake Charles, Louisiana; Tuscaloosa and Montgomery in Alabama; Detroit, Dearborn, and Royal Oak in Michigan; Oxford, Mississippi; and the Bronx and Manhattan in New York.

Bynum wasn’t entirely surprised by the findings, she said.

She anticipated variations in the rate of formal diagnosis, she stated, depending on how clinics and individual physicians typically handle patients with cognitive issues.

She stated that the pattern of high and low diagnosis intensity areas not being located in areas with a higher burden of disease in the population was less expected.

"In areas where dementia is more prevalent, there may be a greater push to place those affected in care."

Dr. Lycia Neumann, the senior director of health services research at the Alzheimer's Association, commented on how the study highlights regional disparities in the diagnosis of Alzheimer's and other dementias, despite not being involved in the study.

If health systems, payers, and governments do not make a deliberate effort to promote equal access to diagnosis, the disparity gaps will persist and widen, according to her statement to Planet Chronicle Digital.

Overcoming barriers to diagnosis

To address concerns about cognitive decline among family members, individuals may need to "exert additional effort" in discussing their worries with their primary physicians, according to Bynum.

The concern of older adults can get lost among other things they and their doctors discuss, and sorting out cognitive complaints is difficult for doctors, she said in an interview with Planet Chronicle Digital.

"We should also urge our local health systems to enhance their ability to cater to the growing population by implementing clinical and supportive programs."

Younger individuals and those from historically underrepresented ethnic and racialized groups are more likely to be underdiagnosed, according to Neumann.

At all levels, there are barriers to an early and precise dementia diagnosis, as she stated.

"From stigma and low awareness of symptoms to obstacles to healthcare access due to insurance coverage, distance to clinics, and transportation and companionship issues."

Neumann hopes that this study will inspire awareness of early warning signs and motivate individuals to share their health concerns with their providers.

"Barriers to an early and precise dementia diagnosis exist at all levels."

She stated that educational programs and interventions can aid in obtaining timely dementia diagnoses.

"An accurate diagnosis is crucial for effective treatment and care."

Potential limitations

Bynum pointed out that one of the study's limitations is that the researchers could not determine whether the rate of diagnosis is "too high or too low" based solely on their data.

She stated that it is either above or below the national average rate.

"Determining the precise number of dementia patients in each community would be extremely expensive to assess."

According to Bynum, this approach can aid researchers in comprehending whether obtaining a formal diagnosis is more or less challenging in various geographical regions.

Neumann pointed out that studies based on claims data are subject to limitations.

"The data only includes information about individuals who have received care, specifically a diagnosis, which means it does not include people who may be living with the disease but have not been able to access the healthcare system or receive an accurate diagnosis."

The information gathered in medical claims is primarily used for payment and reimbursement purposes, not for research, which limits our ability to comprehend the underlying factors contributing to disparities.

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Medicare fee-for-service enrollees, specifically older adults, make up the entire study population, according to Neumann.