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• Posted November 28, 2023

Black Patients Wait Longer Than Whites for Alzheimer's Diagnosis

Medical imaging for thinking and memory issues happens much later in Black patients than in their white and Hispanic counterparts, new research shows.

A study to be presented Thursday at a meeting of radiologists also revealed that Black patients were less often tested with MRIs, a preferred way to identify brain abnormalities that can cause cognitive issues.

Other research has found that Black people have a greater risk of Alzheimer's disease and other types of dementia and they are more likely to be diagnosed later than white patients.

"If disparity in obtaining access to neuroimaging is one possible barrier that delays diagnosis, it is important to identify this and figure out possible solutions to benefit these patients and prevent a delayed diagnosis," said lead author Dr. Joshua Wibecan, a radiology resident at Boston Medical Center.

Increasingly, imaging with MRI plays a big part in diagnosing thinking impairments. But it has been unclear how differences in access to imaging may lead to delayed diagnoses.

Wibecan's team studied four years of imaging data at Boston Medical Center. As a safety net medical center, it cares for people regardless of their ability to pay or insurance status.

Researchers identified all outpatient CTs and CT angiographies of the head, as well as MRI brain exams done for mental impairment.

Self-identified Black patients were older when they received imaging and were less often examined with MRI for cognitive impairment, the study found. Though CT and MRI both help detect thinking declines and dementia, MRI offers much more detail about brain abnormalities.

"Our study demonstrates two main findings," Wibecan said in a Radiological Society of North America (RSNA) news release. "First, Black patients who received MRI or CT for cognitive impairment were significantly older than patients from other races. Second, Black patients were significantly less likely to be imaged with MRI, the optimal type of imaging for cognitive impairment, as opposed to CT."

On average, Black patients were 72.5 years old when they underwent imaging, researchers found, compared to 67.8 years for white patients; 66.5 years for Hispanic patients; and 66.7 for others.

In all, nearly 51% of Black patients had MRIs for cognitive impairment, compared to 60% of white patients; 67% of Hispanic patients; and 68.2% of others, the study showed.

Researchers noted that early evaluation with brain images is important because it identifies treatable causes of mental impairment, including tumors, bleeding or swelling within the brain. Early diagnosis also means patients may get access sooner to new Alzheimer's treatments that can slow decline.

"As treatment for Alzheimer's disease improves, it will be even more important to identify patients at early stages of disease for optimal treatment," Wibecan explained.

He said further study is needed to more clearly understand the significant differences in type of imaging ordered across racial groups.

Wibecan plans to present the findings Thursday at the RSNA annual meeting in Chicago. Research presented at meetings is typically considered preliminary until published in a peer-reviewed journal.

More information

The Alzheimer's Association has more about brain imaging tests and other tools to diagnose thinking impairments.

SOURCE: Radiological Society of North America, news release, Nov. 27, 2023