Ethnic Variations in Patient Outcomes in a Memory Clinic Setting Between 2013 and 2021

Article type: Research Article

Authors: Chithiramohan, Tamara^{a; b; *} | Threlfall, Grace^b | Abdelaziz, Hanin^b | Ellahi, Amira^b | Subramaniam, Hari^{b; c} | Beishon, Lucy^a | Mukaetova-Ladinska, Elizabeta B.^{b; c}

Affiliations: [a] University of Leicester, Department of Cardiovascular Sciences, Leicester, UK | [b] Leicestershire Partnership NHS Trust, Leicester, UK | [c] Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK

Correspondence: [*] Correspondence to: Tamara Chithiramohan, Room 414, Robert Kilpatrick Building, Leicester Royal Infirmary, Infirmary Square, LE1 5WW, UK. Tel.: +44 07500661949; E-mail: tamara.chithiramohan1@nhs.net.

Abstract: Background:The incidence of dementia in Black and Asian populations in the UK is set to rise. There is concern surrounding differences in services provided for different ethnic groups. Objective:This study aimed to examine ethnic variations in survival, services accessed, and medication use across White, Black, and Asian groups in routine memory clinic setting. Methods:We retrospectively examined referrals to a memory service between 2013 and 2021. A random sample of 104 White, 99 Asian, and 74 Black patients were analyzed for differences in support services, voluntary services, medication use, and survival rate. Results:There were statistically significant differences in survival of the Asian compared to the White group (Hazard ratio (HR = 2.17,95% confidence interval (CI) 1.23–3.85, p = 0.008)) following adjustment for age, gender, diagnosis, cognitive impairment, severity, access to support and voluntary services, and use of cholinesterase inhibitors, N-methyl-D-aspartate antagonists, and antipsychotics. The Asian group showed a statistically significantly reduction in access to support services compared to the White group (HR = 0.05, 95% CI 0.01–0.37, p = 0.003). In contrast, the survival rate was similar between the White and Black dementia patients. Conclusion:We found significantly reduced survival and reduced access to support services in Asian compared to White patients with dementia. Further research is needed to investigate the generalizability of our results, and determine the cause, and consequent remedies of these associations in ethnic minority groups.

Keywords: Dementia, ethnicity, Leicester, memory, support, survival

DOI: 10.3233/JAD-220925

Journal: Journal of Alzheimer's Disease, vol. 92, no. 1, pp. 71-79, 2023