title: Inequalities in Access to Treatment and Care for Patients with Dementia and Immigrant Background: A Danish Nationwide Study.
abstract: Previous studies demonstrated lower quality diagnostic assessment of dementia in immigrant populations, but knowledge about the quality of treatment and care for dementia is still lacking.
  
  
  
  To conduct a nationwide registry-based study to determine whether inequality exists regarding access to anti-dementia treatment and care between immigrant and Danish-born patients with dementia.
  
  
  
  A cross-sectional register-based study was conducted in the entire elderly (60≥years) population with dementia in Denmark in 2012 (n = 34,877). The use of anti-dementia drugs and residency in a nursing home were compared among Danish-born and Western and non-Western immigrants with dementia. Logistic regression analysis was done with adjustment for age, sex, comorbidity, marital status, basis of inclusion, and time since dementia diagnosis.
  
  
  
  Immigrant background was associated with a significantly lower likelihood of receiving anti-dementia drug therapy (odds ratio (OR) [95% confidence interval (CI)]): non-Western = 0.70 [0.56-0.87]; Western = 0.74 [0.63-0.87]). No significant differences were found in type or amount of anti-dementia medication dispensed between the population groups (proxy measure for adherence). Non-Western immigrants were significantly less likely to live in a nursing home (0.52 [0.41-0.65]).
  
  
  
  This nationwide registry-based study indicated a worrisome difference in access to anti-dementia treatment and care for dementia patients with an immigrant background, but similar levels of adherence compared with the Danish-born population. Further research is necessary to pinpoint barriers to access to suitable healthcare among elderly immigrants with dementia but also to identify and develop culturally sensitive methods for their treatment and care.
authors: Danish Dementia Research Centre (DDRC), Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors: Lea
authors: L
authors: Stevnsborg
authors: Danish Dementia Research Centre (DDRC), Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors: Christina
authors: C
authors: Jensen-Dahm
authors: Danish Dementia Research Centre (DDRC), Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors: Thomas R
authors: TR
authors: Nielsen
authors: National Centre for Register-Based Research, Aarhus University, School of Business and Social Sciences, Aarhus, Denmark.
authors: Christiane
authors: C
authors: Gasse
authors: Danish Dementia Research Centre (DDRC), Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors: Gunhild
authors: G
authors: Waldemar
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003704:Dementia / Q000191:economics* / Q000453:epidemiology / Q000628:therapy*; D003718:Denmark / Q000453:epidemiology; D054242:Emigrants and Immigrants; D005260:Female; D006297:Health Services Accessibility / Q000191:economics* / Q000639:trends; D054625:Healthcare Disparities / Q000191:economics* / Q000639:trends; D006801:Humans; D008297:Male; D009735:Nursing Homes / Q000191:economics / Q000639:trends; D012042:Registries
keywords: Dementia; drug therapy; emigrants and immigrants and; healthcare 
  disparities; medication adherence; nursing homes