Ethnic Differences in Dementia Diagnosis and Treatment in Israel

Background/Objectives: Lifestyle and socioeconomic disparities influence dementia prevalence and treatment across ethnic groups worldwide. Our study aimed to examine differences in the diagnosis, work-up, and treatment of mild cognitive impairment (MCI) as well as various types of dementia provided to Arab and Jewish participants in Israel. Methods: Data were collected retrospectively and anonymously between 1 January 2010 and 12 September 2021, by Clalit Health Services' research department. Ethnicity was determined based on residence, including only cities with a 99% majority of either Jewish or Arab participants, according to the Central Bureau of Statistics (CBS). Subjects over the age of 60 with an MCI or dementia diagnosis were analyzed. Results: Of 212,091 diagnosed individuals, 14,742 were of a definite ethnicity as defined. The mean age at diagnosis was significantly younger for Arab participants (75.78 ± 10.28) compared to Jewish participants (80.14 ± 9.45) (p < 0.001). The gender distribution was similar (42.5% male). The most common diagnosis was Alzheimer's disease (AD), affecting 2495 (29.8%) of Jewish participants and 2387 (38%) of Arab participants (p < 0.001). Vascular dementia (VD) was also more prevalent in Arab participants, 12.6%, vs. 6.42% in Jewish participants (p < 0.001). MCI was more common in Jewish participants, 26.2%, compared to 10.3% in Arab participants (p < 0.001). Conclusions: Arab participants were diagnosed with dementia at a younger age and showed higher rates of AD and VD diagnosis compared to Jewish participants, but were significantly less likely to be diagnosed with MCI. Efforts to understand and address these underlying causes are warranted to promote health equity.