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Differences in Dementia Care Between Swedish-Born and Foreign-Born from Countries with Different Country Level Socioeconomic Position : A Nationwide Register-Based Study

Lindgren, Emma LU ; Sörenson, Josephine ; Wattmo, Carina LU ; Kåreholt, Ingemar and Nägga, Katarina LU (2021) In Journal of Alzheimer's disease : JAD 84(3). p.1363-1371
Abstract

BACKGROUND: With a growing elderly population worldwide, the prevalence of dementia is rapidly increasing. Studies from high income countries have shown that belonging to a minority ethnic group increases the risk of health disadvantages.

OBJECTIVE: The aim of the present registry-based study was to identify potential differences in diagnostics, treatment, and care of individuals with dementia focusing on foreign-born in Sweden and the impact of country level socioeconomic position (SEP).

METHODS: The study was based on a large dataset from the Swedish Dementia Registry (SveDem) and the Swedish Tax Agency's population registry. Data on demographic variables, cognitive tests, clinical assessments, medication, diagnosis, and... (More)

BACKGROUND: With a growing elderly population worldwide, the prevalence of dementia is rapidly increasing. Studies from high income countries have shown that belonging to a minority ethnic group increases the risk of health disadvantages.

OBJECTIVE: The aim of the present registry-based study was to identify potential differences in diagnostics, treatment, and care of individuals with dementia focusing on foreign-born in Sweden and the impact of country level socioeconomic position (SEP).

METHODS: The study was based on a large dataset from the Swedish Dementia Registry (SveDem) and the Swedish Tax Agency's population registry. Data on demographic variables, cognitive tests, clinical assessments, medication, diagnosis, and interventions initiated at diagnosis were collected. Country level SEP was determined by country of birth as classified by World Bank Country and Lending groups.

RESULTS: Of 57,982 patients with dementia registered in SveDem, 7,171 (12.4%) were foreign-born. The foreign-born were significantly younger at diagnosis (p < 0.001), had a lower MMSE score (p < 0.001), lower odds of receiving a specific dementia diagnosis (p < 0.001), lower use of acetylcholinesterase inhibitors (p < 0.001), and overall a higher use of neuroleptics compared with the Swedish-born group. The lower SEP, the greater differences to Swedish-born were seen in many of the examined variables.

CONCLUSION: There were significant differences in dementia diagnostics, treatment, and care between foreign-born and Swedish-born, a lower SEP indicating greater differences. Further research should focus on various socioeconomic aspects and health care outcomes for a more profound analysis of equity in dementia care.

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Please use this url to cite or link to this publication:
author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Alzheimer's disease : JAD
volume
84
issue
3
pages
1363 - 1371
publisher
IOS Press
external identifiers
  • pmid:34657886
  • scopus:85120504185
ISSN
1387-2877
DOI
10.3233/JAD-210734
language
English
LU publication?
yes
id
b99c4b7f-ce8a-4d8a-b178-3c584067ab76
date added to LUP
2021-11-29 09:16:57
date last changed
2024-06-17 00:24:09
@article{b99c4b7f-ce8a-4d8a-b178-3c584067ab76,
  abstract     = {{<p>BACKGROUND: With a growing elderly population worldwide, the prevalence of dementia is rapidly increasing. Studies from high income countries have shown that belonging to a minority ethnic group increases the risk of health disadvantages.</p><p>OBJECTIVE: The aim of the present registry-based study was to identify potential differences in diagnostics, treatment, and care of individuals with dementia focusing on foreign-born in Sweden and the impact of country level socioeconomic position (SEP).</p><p>METHODS: The study was based on a large dataset from the Swedish Dementia Registry (SveDem) and the Swedish Tax Agency's population registry. Data on demographic variables, cognitive tests, clinical assessments, medication, diagnosis, and interventions initiated at diagnosis were collected. Country level SEP was determined by country of birth as classified by World Bank Country and Lending groups.</p><p>RESULTS: Of 57,982 patients with dementia registered in SveDem, 7,171 (12.4%) were foreign-born. The foreign-born were significantly younger at diagnosis (p &lt; 0.001), had a lower MMSE score (p &lt; 0.001), lower odds of receiving a specific dementia diagnosis (p &lt; 0.001), lower use of acetylcholinesterase inhibitors (p &lt; 0.001), and overall a higher use of neuroleptics compared with the Swedish-born group. The lower SEP, the greater differences to Swedish-born were seen in many of the examined variables.</p><p>CONCLUSION: There were significant differences in dementia diagnostics, treatment, and care between foreign-born and Swedish-born, a lower SEP indicating greater differences. Further research should focus on various socioeconomic aspects and health care outcomes for a more profound analysis of equity in dementia care.</p>}},
  author       = {{Lindgren, Emma and Sörenson, Josephine and Wattmo, Carina and Kåreholt, Ingemar and Nägga, Katarina}},
  issn         = {{1387-2877}},
  language     = {{eng}},
  number       = {{3}},
  pages        = {{1363--1371}},
  publisher    = {{IOS Press}},
  series       = {{Journal of Alzheimer's disease : JAD}},
  title        = {{Differences in Dementia Care Between Swedish-Born and Foreign-Born from Countries with Different Country Level Socioeconomic Position : A Nationwide Register-Based Study}},
  url          = {{https://lup.lub.lu.se/search/files/110305732/Lindgren_Differences_dementia_care_Swedish_Born_vs_Foreign_born.pdf}},
  doi          = {{10.3233/JAD-210734}},
  volume       = {{84}},
  year         = {{2021}},
}