Dementia Care Patterns In The US Vary By Clinician Type: Evidence From A National Workforce Study, 2024-25

The prevalence of Alzheimer's disease and related dementias (ADRD) is increasing. Amid specialist shortages and growing reliance on advanced practice providers, high-quality dementia care across clinician types is a public health priority in the US, with important implications for workforce and care delivery policy. However, little is known about how dementia care varies by clinician type. Using novel, nationally representative data from 4,699 clinicians in the 2024-25 Community Clinician survey of the National Dementia Workforce Study, we conducted multivariable analyses to compare diagnostic confidence, assessment practices, and care delivery among advanced practice providers, primary care physicians, and specialists. Compared with primary care physicians, specialists reported greater confidence in diagnosing dementia and mild cognitive impairment among patients younger than age sixty-five and among those with Alzheimer's dementia, whereas advanced practice providers reported lower diagnostic confidence and were less likely to order or perform most advanced diagnostic testing and cognitive assessments. Specialists were more likely to focus on screening and managing behavioral symptoms, whereas advanced practice providers were more likely to prescribe anti-amyloid therapy. These findings highlight the importance of payment and workforce policies that support team-based dementia care and effectively integrate clinicians with different roles and training.