TY - JOUR T1 - Racial disparities and temporal trends in dementia misdiagnosis risk in the United States JF - Alzheimer's and Dementia: Translational Research and Clinical Interventions Y1 - 2019 A1 - Kan Z Gianattasio A1 - Prather, C. A1 - M. Maria Glymour A1 - Ciarleglio, A. A1 - Melinda C Power KW - Aged KW - algorithm KW - ancestry group KW - Article KW - Black person KW - Caucasian KW - Dementia KW - diagnostic error KW - ethnic group KW - Female KW - health disparity KW - human KW - ICD-9-CM KW - major clinical study KW - Male KW - Medicare KW - priority journal KW - Retirement KW - risk factor KW - sensitivity analysis KW - Sensitivity and Specificity KW - United States AB - Introduction: Systematic disparities in misdiagnosis of dementia across racial/ethnic groups have implications for health disparities. We compared the risk of dementia under- and overdiagnosis in clinical settings across racial/ethnic groups from 2000 to 2010. Methods: We linked fee-for-service Medicare claims to participants aged ≥70 from the nationally representative Health and Retirement Study. We classified dementia status using an algorithm with similar sensitivity and specificity across racial/ethnic groups and assigned clinical dementia diagnosis status using ICD-9-CM codes from Medicare claims. Multinomial logit models were used to estimate relative risks of clinical under- and overdiagnosis between groups and over time. Results: Non-Hispanic blacks had roughly double the risk of underdiagnosis as non-Hispanic whites. While primary analyses suggested a shrinking disparity over time, this was not robust to sensitivity analyses or adjustment for covariates. Risk of overdiagnosis increased over time in both groups. Discussion: Our results suggest that efforts to reduce racial disparities in underdiagnosis are warranted. © 2019 The Authors VL - 5 ER -