Social determinants of racial and ethnic disparities in ADRD diagnostic pathways

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Principal Investigator: Elena  Tsoy
Organization: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
Fiscal Year: 2024
Award: $161,500
Funding agency: National Institute on Aging

PROJECT SUMMARY / ABSTRACT
The U.S. aging population is rapidly becoming more racially and ethnically diverse and addressing persistent
disparities in Alzheimer's disease and related dementias (ADRD) diagnosis and care is an urgent research
priority. Fundamentally, the causes of these disparities remain gravely understudied and the mechanisms
underlying racial and ethnic healthcare inequities are lacking. The primary goal of this project is to elucidate the
role of social determinants of health in racial and ethnic disparities in ADRD diagnosis and care using data from
a nationally representative cohort of Medicare beneficiaries enrolled in the Medicare Current Beneficiary Survey
(MCBS) linked to administrative claims data. The overarching hypothesis of this study is that social factors will
substantially mediate the relationship between race and ethnicity and ADRD diagnostic and access to care
outcomes. In Aim 1, we will identify key social determinants associated with the timeliness of ADRD diagnosis,
etiological specificity of ADRD diagnosis, and access to ADRD diagnostic care (specialty evaluation and
recommended diagnostic services). In Aim 2, we will empirically test the role of key social determinants of health
as mediators of racial and ethnic disparities in diagnostic and access to care outcomes. The findings will provide
critical contributions to existing health disparities frameworks and, if our hypotheses are supported, will have
direct implications for clinical care by identifying most vulnerable populations in need for interventions and
facilitating the establishment of diagnostic pipelines to guide practitioners and healthcare systems aimed at
reducing health inequities in ADRD.

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