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Association between experiencing low healthcare quality and developing dementia.
José M Aravena1,2, Xi Chen3, Becca R Levy1,4
1Department of Social & Behavioral Sciences, School of Public Health, Yale University, New Haven, Connecticut, USA.
Journal of the American Geriatrics Society
|February 28, 2024
Summary
Experiencing low healthcare quality, including discrimination and dissatisfaction, significantly increases dementia risk in older adults. Improving healthcare delivery may help reduce dementia prevalence.
Area of Science:
- Gerontology
- Public Health
- Neurology
Background:
- Low healthcare quality is a known predictor of various illnesses in older adults.
- Its role in dementia development has not been previously established.
- This study investigates the association between low healthcare quality and dementia incidence in older populations.
Purpose of the Study:
- To determine if experiencing low healthcare quality is associated with an increased risk of developing dementia.
- To examine the specific impact of healthcare discrimination and dissatisfaction on dementia risk.
Main Methods:
- Analysis of data from 3795 participants (aged 60+) in the Health and Retirement Study (2006-2019).
- Low healthcare quality assessed via discrimination and dissatisfaction metrics.
- Dementia incidence determined by physician diagnosis or cognitive testing (Telephone Interview for Cognitive Status).
- Cox regression models used to calculate adjusted hazard ratios for dementia risk.
Main Results:
- A total of 700 out of 3795 participants developed dementia over the follow-up period.
- Experiencing low healthcare quality was significantly associated with a 50% increased risk of dementia (adjusted HR: 1.50, 95% CI: 1.12-2.01).
- Both healthcare discrimination and dissatisfaction independently predicted higher dementia risk.
Conclusions:
- The study confirms that low healthcare quality is linked to a greater risk of dementia in older adults.
- Findings suggest that structural improvements in healthcare delivery, not just individual behaviors, could be key to reducing dementia prevalence.
- Interventions aimed at enhancing healthcare quality may play a role in dementia prevention strategies.
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