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Dementia appears more likely in black ethnic groups

Dementia diagnosis 28% higher in black men than in white men

Adrian O'Dowd

Thursday, 09 August 2018

Rates of dementia diagnosis are higher among black ethnic groups than in Asian groups and white people in the UK, according to a study* published in the journal Clinical Epidemiology.

The University College London (UCL) led study claims to be the first to compare incidence of dementia diagnosis by ethnicity in any nationally representative sample.

Researchers from UCL and King’s College London analysed data from 2,511,681 people, including 66,083 who had a dementia diagnosis, from The Health Improvement Network primary care database between 2007 and 2015.

They found that the incidence of dementia diagnosis was 28% higher among black men than white men and 25% higher among black women than white women.

Asian men and women were 12% and 18% less likely than white men and women, respectively, to have a dementia diagnosis.

The authors said that more research was needed to understand why people in certain ethnic groups were more likely to develop dementia.

They theorised that factors such as level of formal education, financial deprivation, smoking, physical activity, mental health and some mid-life health outcomes, which all affect dementia risk, differed between the groups.

Other research has found that South Asian people may have a lower genetic risk of getting dementia.

Study lead author Dr Claudia Cooper from UCL Psychiatry, said: “Our new findings may reflect, for example, that there are inequalities in the care people receive to prevent and treat illnesses associated with dementia.

“Or perhaps GPs or patients’ families are reluctant to name dementia in communities where more stigma is associated with a dementia diagnosis.”

The research team also compared the diagnosis rates to what could be expected in the different groups as predicted by prior research.

Co-author Dr Tra My Pham from UCL Institute of Epidemiology & Health, said: “What we found suggests that the rates of people receiving a diagnosis may be lower than the actual rates of dementia in certain groups, particularly among black men.

“It is concerning that black people appear to be more at risk of dementia but less likely to receive a timely diagnosis.”

The researchers said they could not yet explain the lower dementia rates they found among people of Asian descent.

Dr Cooper added: “Perhaps British Asians do have a lower risk, or they may only be less likely to be diagnosed when they develop it.

“Rates of timely diagnosis in the UK have been improving, but it appears that not all groups of society are benefiting equally. It’s important that messages that dementia is best diagnosed early are tailored to different groups. We’ve previously found that people’s cultural background can influence how willing or unwilling they are to seek help.”

Dr Doug Brown, chief policy and research officer at the Alzheimer’s Society, said: “This research adds flesh to the bones of a worrying pattern we’re starting to see in the UK. Black men are receiving fewer diagnoses than white men, despite prevalence being higher amongst black men.

“It is vital that everyone has equal access to a diagnosis, regardless of their race, gender, age or postcode, and we will continue to build on our work with government to make sure this happens.”

*Pham, T M et al. Trends in dementia diagnosis rates in UK ethnic groups: analysis of UK primary care data. Clinical Epidemiology 2018:10 949–960. DOI:10.2147/CLEP.S152647

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