Examining misdiagnosis of mild cognitive impairment among Black/African American older adults. (31st December 2021)

• Record Type: Journal Article
• Authors: Kiselica, Andrew M; Johnson, Ellen; Lewis, Kaleea; Trout, Kate
• Is Part Of: Alzheimer's & dementia. Volume 17(2021)Supplement 6
• Page Start: n/a
• Page End: n/a
• Publication Date: 2021-12-31
• Subjects: Alzheimer's disease -- Periodicals; Alzheimer Disease -- Periodicals; Dementia -- Periodicals; Démence; Maladie d'Alzheimer; Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); 616.83
• DOI: 10.1002/alz.049776
• Languages: English
• ISSNs: 1552-5260

Abstract

Abstract: Background: Black/African Americans are less likely to receive an accurate diagnosis of mild cognitive impairment (MCI) than their White counterparts. We examined rates of low cognitive test scores by race among older adults diagnosed with MCI to illuminate possible biases in the diagnostic process. Method: We compared number of low scores (i.e., <9th percentile) on cognitive tests between Black ( n = 545) and White ( n = 3, 542) participants diagnosed with MCI based on the Clinical Dementia Rating. Participants were drawn from the National Alzheimer's Coordinating Center Uniform Data Set. Chi‐square tests were used to examine racial differences in rates of low scores for each cognitive test, and t ‐tests were used to compare the number of low scores across groups. Result: Compared to Black participants, White individuals demonstrated significantly higher rates of low scores on tests of memory, attention, and verbal fluency. White participants with MCI also evidenced a higher number of low scores overall ( M = 3.67, SD = 2.46) than Black participants ( M = 2.46, SD = 2.15), d = .48. Conclusion: Results suggest there may be bias in MCI classification based on clinical interview, leading to overdiagnosis among Black individuals and/or underdiagnosis among White individuals.