A new study by Queen Mary University of London finds significant differences in how various ethnic groups report early dementia symptoms, suggesting that cultural factors influence diagnosis and access to care.
A recent study led by Queen Mary University of London has uncovered significant variations in how individuals from different ethnic backgrounds report symptoms before receiving a dementia diagnosis. The findings, set to be published in the journal Alzheimer’s & Dementia on Feb. 26, suggest that these differences could contribute to delays in diagnosis and treatment, highlighting an urgent need for more inclusive diagnostic procedures.
The most common route to a dementia diagnosis is through consultations with general practitioners (GPs) for memory difficulties. However, early dementia can manifest in other ways, including depression, weight loss, low blood pressure and dizziness.
Cultural backgrounds heavily influence the symptoms patients are likely to discuss with their GPs.
“Getting a timely dementia diagnosis requires prompt recognition of symptoms that suggest that somebody might be developing dementia,” Charles Marshall, a professor of clinical neurology and lead of dementia research at Queen Mary’s Centre for Preventive Neurology, said in a news release. “We tend to focus mainly on memory problems as the reason for assessing someone for dementia, but this is a problem because dementia doesn’t just affect memory, and because for cultural reasons people may be more or less likely to report memory difficulty to their GP.”
The study was conducted in response to observations from the Hackney Caribbean Elderly Organisation, whose members often described physical pain rather than cognitive symptoms when discussing dementia.
Previous research predominantly involved white patients, creating a gap in understanding how early symptoms present in more diverse populations. Funded by the NIHR Three Schools Dementia Programme, Marshall’s team assessed over 1 million primary care electronic health records in East London, including data from 4,137 individuals diagnosed with dementia and 15,754 controls.
The researchers analyzed symptoms reported to GPs up to 10 years prior to a dementia diagnosis, comparing them with those of similar age and demographics who did not have dementia.
Symptoms examined included depression, anxiety, use of antipsychotics, insomnia, constipation, incontinence, hypotension, hearing loss, pain, imbalance and dizziness.
The study revealed that Black and South Asian individuals reported symptoms such as constipation, incontinence, imbalance, dizziness, musculoskeletal pain and insomnia more commonly than their white counterparts. This could be due to stigma, distrust in health care systems or other sociocultural factors.
Richard Oakley, associate director of research and innovation at Alzheimer’s Society, emphasized the importance of this research.
“Around one million people in the UK are living with dementia, but a third of these have not received a diagnosis. This is despite us knowing that an early and accurate diagnosis is key to ensuring everyone has access to the treatment, care and support they deserve,” Oakley said in the news release. “Dementia affects every part of the population, and research shows that people from Black and South Asian backgrounds have a higher risk of developing dementia. However, they are often underrepresented in dementia studies, so it’s excellent to see this research, which is the first to explore how the early signs of dementia are reported to clinicians by diverse groups.”
The study’s insights are pivotal for developing diagnostic approaches that can accommodate cultural differences, ensuring equitable dementia care across all communities.
“We hope that this work will improve culture-fair recognition of possible dementia in primary care so that everyone can benefit equally from diagnosis, care and emerging treatments for dementia,” Marshall added.
Oakley urges those who are worried about themselves or others to check their symptoms using Alzheimer’s Society’s symptom checklist here.