A recent study has shed light on a significant factor influencing Alzheimer’s disease diagnoses in the United States: geography. According to research conducted by the University of Michigan and Dartmouth College, the likelihood of receiving a formal diagnosis of Alzheimer’s or related dementias may depend heavily on where one lives, revealing stark disparities across different regions of the country.
With approximately 7 million people in the U.S. living with Alzheimer’s and related dementias, the study found that diagnosis rates vary widely, a disparity not fully explained by common risk factors such as hypertension, obesity, and diabetes. The study, published in the journal Alzheimer’s & Dementia, suggests that access to primary care, availability of specialists, and social stigma may all contribute to these differences.
Julie Bynum, the study’s lead author and a geriatrician at the University of Michigan Medical School, emphasized the real-world impact of these findings: “We often hear how difficult it can be to get an Alzheimer’s diagnosis, and our research confirms that this challenge is not uniform across the country. The variability in diagnosis rates is not just anecdotal—it’s a documented reality.”
The study’s implications are profound. A formal diagnosis of Alzheimer’s is crucial for accessing treatments that may slow disease progression, eligibility for clinical trials, and insurance coverage for specific medications. Even when treatment isn’t viable, a diagnosis is essential for planning patient care.
Researchers used Medicare and demographic data to map out diagnosis rates across 306 hospital referral regions (HRRs) in the U.S., comparing actual diagnosis rates with expected rates based on local health risk factors and demographics. The results showed significant differences between these maps, with regions such as the Great Plains and the Southwest reporting fewer diagnoses than anticipated. For instance, someone in Wichita Falls, Texas, is twice as likely to receive a diagnosis compared to someone in Minot, North Dakota.
The study also highlights the broader issue of healthcare access. Erin Abner, an epidemiologist at the University of Kentucky, noted, “Where we live has a profound influence on our brain health. Access to behavioral neurological specialists is severely limited in many parts of the country, with waiting lists often extending for months or even years.”
In addition to healthcare access, language and cultural barriers further complicate the diagnosis process. Diagnosing Alzheimer’s typically involves a series of cognitive and neuropsychological assessments, along with tests to detect amyloid plaques in the brain. These complexities are compounded in regions where healthcare resources are scarce.
Bynum hopes that the study will spark greater awareness of the role healthcare systems play in diagnosing Alzheimer’s and related dementias. “It’s not just about individual risk factors,” Bynum stated. “The healthcare and public health systems have a significant role in informing and educating populations, and there’s a lot we can do to improve this.”
As new blood tests and diagnostic tools for Alzheimer’s become available, understanding these geographic disparities will be crucial in ensuring equitable access to care and early diagnosis for all Americans, regardless of where they live.