2023 Alzheimer's Association Research Fellowship (AARF)

Variation in Dementia Diagnosis Across Primary Care Physicians

How and why do different primary care physicians diagnose dementia at different rates?

Sidra Haye, Ph.D.
University of Southern California
Los Angeles, CA - United States

Background

Alzheimer’s and other dementia are progressive disorders, and it is important to diagnose them at an early stage, when treatments can be most effective. Many individuals in the United States, however, do not receive a timely dementia diagnosis, a problem that has many potential causes. Black and Hispanic Americans, for example, may not get properly diagnosed because of a lack of access to quality health care. Older adults with certain health care plans, including certain types of Medicare, may also be less likely to receive a dementia diagnosis. 

Another factor linked to dementia diagnostic rates is the primary care physician (PCP). Most dementia diagnoses in the United States are delivered by PCPs, yet there is a significant discrepancy in the quality and rate of diagnoses among U.S. primary care physicians. Understanding these discrepancies, and the reasons for them, will be necessary to improve dementia diagnosis and care overall.

Research Plan

Dr. Sidra Haye and colleagues will study how and why diagnostic rates for dementia differ among primary care physicians. They will use a variety of medical and other information from Medicare claims data – including data from traditional Medicare (Medicare Parts A and B) and Medicare Advantage (Medicare Part C). These data include physician practice information and the demographic and insurance status of PCP patients. The researchers will compare how PCP dementia diagnosis rates differ (1) for patients with different Medicare plans and (2) for patients of different races and ethnicities. Next, they will examine the various PCP-related factors that may help explain these variations in diagnosis rates: factors such as the size of a PCP’s practice and the types of dementia specialists that PCPs may refer to their patients. 

Impact

Dr. Haye’s study could shed new light on the factors that hinder or promote effective dementia diagnoses by primary care physicians. Such results could be used by policy makers and medical institutions to improve dementia care – especially for underserved or at-risk individuals.
 

This project was made possible by the Dale Schenk Alzheimer's Association Research Roundtable Award