title: Inequalities in receipt of mental and physical healthcare in people with dementia in the UK.
abstract: UK Dementia Strategies prioritise fair access to mental and physical healthcare. We investigated whether there are inequalities by deprivation or gender in healthcare received by people with dementia, and compared healthcare received by people with and without dementia.
  
  
  
  we investigated primary care records of 68,061 community dwelling dementia patients and 259,337 people without dementia (2002-13). We tested hypotheses that people with dementia from more deprived areas, and who are women receive more psychotropic medication, fewer surgery consultations, are less likely to receive annual blood pressure, weight monitoring and an annual review, compared with those from less deprived areas and men.
  
  
  
  only half of people with dementia received a documented annual review. Deprivation was not associated with healthcare received. Compared to men with dementia, women with dementia had lower rates of surgery consultations (adjusted incidence rate ratio (IRR) 0.90, 95% CI 0.90-0.91), of annual blood pressure monitoring (adjusted IRR 0.96, 95% CI 0.95-0.97) and of annual weight monitoring (adjusted IRR 0.91, 95% CI 0.90-0.93). Men with dementia were less likely to be taking psychotropic medication than women with dementia. People with dementia had fewer surgery consultations and were less likely to have their weight and blood pressure monitored at least annually, compared to the non-dementia group.
  
  
  
  people with dementia, in particular women, appear to receive less primary healthcare, but take more psychotropic medication that may negatively impact their physical health. Reducing these inequalities and improving access of people with dementia to preventative healthcare could improve the health of people with dementia.
authors.affiliation: Camden and Islington Mental Health and Social Care Trust, Psychiatry of Older People, Archway Campus Holborn Union Building, Highgate Hill, London N19 5NL, United Kingdom of Great Britain and Northern Ireland.
authors.forename: Claudia
authors.initials: C
authors.lastname: Cooper
authors.affiliation: University College London, London, United Kingdom of Great Britain and Northern Ireland.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Lodwick
authors.affiliation: University College London, London, United Kingdom of Great Britain and Northern Ireland.
authors.forename: Kate
authors.initials: K
authors.lastname: Walters
authors.affiliation: UCL, Epidemiology & Public Health, London, United Kingdom of Great Britain and Northern Ireland.
authors.forename: Rosalind
authors.initials: R
authors.lastname: Raine
authors.affiliation: King's College London, Social Care Workforce Research Unit, London SE1 9NN, United Kingdom of Great Britain and Northern Ireland.
authors.forename: Jill
authors.initials: J
authors.lastname: Manthorpe
authors.affiliation: University College London,  Department of Primary Care & Population Health, London, United Kingdom of Great Britain and Northern Ireland.|UK Dementias & Neurodegenerative Diseases Research Network, London, United Kingdom of Great Britain and Northern Ireland.
authors.forename: Steve
authors.initials: S
authors.lastname: Iliffe
authors.affiliation: University College London, London, United Kingdom of Great Britain and Northern Ireland.
authors.forename: Irene
authors.initials: I
authors.lastname: Petersen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000886:Anthropometry; D001795:Blood Pressure Determination; D001835:Body Weight; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D003704:Dementia / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D005260:Female; D015577:Geriatric Assessment; D006299:Health Services for the Aged / Q000458:organization & administration*; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000458:organization & administration*; D008875:Middle Aged; D011320:Primary Health Care / Q000458:organization & administration*; D011619:Psychotropic Drugs / Q000627:therapeutic use; D012017:Referral and Consultation / Q000458:organization & administration; D012737:Sex Factors; D012959:Socioeconomic Factors; D013514:Surgical Procedures, Operative; D006113:United Kingdom
chemical_list: D011619:Psychotropic Drugs
keywords: dementia; deprivation; equalities; healthcare disparities; medication; older people; psychotropic drugs