Racial/ethnic disparities in initiation and persistent use of anti-dementia medications

Background: Racial/ethnic disparities in anti-dementia medications use in longitudinally followed research participants are unclear. Methods: The study included initially untreated participants followed in National Alzheimer's Coordinating Center Uniform Data Set who were ≥65 at baseline with Alzheimer's disease dementia. Outcomes: Outcomes for acetylcholinesterase inhibitor (AChEI) treatment included (1) any new AChEI treatment during follow-up, and (2) persistence of treatment during follow-up categorized into: intermittent treatment (< 50% follow-ups reporting treatment), persistent (≥50% follow-ups), and always treated. Outcomes for memantine treatment were similarly constructed. Results: Controlling for participant characteristics, Black and Hispanic participants remained less likely than White participants to report any new AChEI or memantine treatment during follow-up. Among those who reported new treatment during follow-up, both Black and Hispanic participants were less likely than White participants to be persistently treated with AChEI and memantine. Discussion: Substantial racial/ethnic treatment disparities remain in controlled settings of longitudinal research in which participants have access to dementia experts, suggesting wider disparities in the larger community.