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Influence of Education and Income on Receipt of Dementia Care in Sweden.
- Source :
-
Journal of the American Medical Directors Association . Oct2021, Vol. 22 Issue 10, p2100-2107. 8p. - Publication Year :
- 2021
-
Abstract
- To explore the dementia diagnostic process and drug prescription for persons with dementia (PWD) with different socioeconomic status (SES). Register-based cohort study. This study included 74,414 PWD aged ≥65 years from the Swedish Dementia Register (2007–2018). Their data were linked with the Swedish Longitudinal Integrated Database for Health Insurance and Labor Market Studies (2006–2017) to acquire the SES information 1 year before dementia diagnosis. Education and income—2 traditional SES indicators—were divided into 5 levels. Outcomes comprised the dementia diagnostic examinations, types of dementia diagnosis, diagnostic unit, and prescription of antidementia drugs. Binary logistic regression was performed to evaluate socioeconomic inequalities. Compared to PWD with the lowest educational level, PWD with the highest educational level had a higher probability of receiving the basic diagnostic workup [odds ratio (OR) 1.19, 95% confidence interval (CI) 1.10-1.29], clock test (OR 1.12, 95% CI 1.02-1.24) and neuroimaging (OR 1.23, 95% CI 1.09-1.39). Compared with PWD in the lowest income quintile, PWD in the highest income quintile presented a higher chance of receiving the basic diagnostic workup (OR 1.35, 95% CI 1.26-1.46), clock test (OR 1.40, 95% CI 1.28-1.52), blood analysis (OR 1.21, 95% CI 1.06-1.39), Mini-Mental State Examination (OR 1.47, 95% CI 1.26-1.70), and neuroimaging (OR 1.30, 95% CI 1.18-1.44). PWD with higher education or income had a higher likelihood of obtaining a specified dementia diagnosis or being diagnosed at a memory clinic. SES presented no association with prescription of antidementia medication, except for the association between education and the use of memantine. Higher education or income was significantly associated with higher chance of receiving dementia diagnostic examinations, a specified dementia diagnosis, being diagnosed at a memory clinic, and using memantine. Socioeconomic inequalities in dementia diagnostic process and prescription of memantine occurred among PWD with different education or income levels. [ABSTRACT FROM AUTHOR]
- Subjects :
- *BLOOD testing
*DIAGNOSIS of dementia
*REPORTING of diseases
*CLINICAL pathology
*HEALTH services accessibility
*CONFIDENCE intervals
*MEMANTINE
*HEALTH status indicators
*DEMENTIA patients
*SOCIOECONOMIC factors
*PSYCHOLOGICAL tests
*DEMENTIA
*NOOTROPIC agents
*DRUGS
*DRUG prescribing
*PHYSICIAN practice patterns
*LOGISTIC regression analysis
*ODDS ratio
*LONGITUDINAL method
*ANTIPSYCHOTIC agents
*NEURORADIOLOGY
Subjects
Details
- Language :
- English
- ISSN :
- 15258610
- Volume :
- 22
- Issue :
- 10
- Database :
- Academic Search Index
- Journal :
- Journal of the American Medical Directors Association
- Publication Type :
- Academic Journal
- Accession number :
- 152632579
- Full Text :
- https://doi.org/10.1016/j.jamda.2021.06.018