(P-503) Effect of Anti-dementia Drugs on and Potential Racial/ethnic Disparities in Satisfaction with Quality of Care Among Older Adults with Alzheimer’s Disease and Related Dementias

Background: The health care system may not be well suited to meeting the complex needs of older adults with Alzheimer’s disease (AD) and related dementias (RD), ADRD.

Objectives: This study aimed to examine the effect of anti-dementia drugs on and racial/ethnic disparities in the satisfaction with quality care based on ADRD among older adults in the U.S.

Methods: A cross-sectional study was designed using 15,206 older adults in the 2017 Medicare Current Beneficiary Survey data. Satisfaction with quality of care was measured by questions on the overall quality of care, the information given, follow-up care, concern for overall health, needs met, availability of night/weekend service, and out-of-pocket costs. Those responding “dissatisfied” or “very dissatisfied” were considered as having received unsatisfactory quality of health care. Multivariable regressions controlling for age, gender, race, educational attainment, family income, marital status, metropolitan residing status, census regions, and comorbidity were implemented.

Results: Compared with ADRD patients who used anti-dementia drugs, those who did not use the drugs were 99% more likely to receive unsatisfactory quality of care (OR=1.99, 95% CI, 1.12-3.52). Specifically, Alzheimer patients and RD patients who used anti-dementia drugs were 174% and 87% more likely to receive unsatisfactory quality of care (AD: OR=2.74, 95% CI, 1.05-7.17; RD: OR=1.87, 95% CI, 1.03-3.39). In addition, compared to ADRD patients who used cholinesterase inhibitors (ChEIs), those who did not use anti-dementia drugs were more likely to receive unsatisfactory quality of care (OR=1.87, 95% CI, 1.01-3.44). Potential race disparities were found in satisfaction with quality of care. Non-Hispanic Blacks were 13% more likely to receive the unsatisfactory quality of care compared to non-Hispanic Whites (OR=1.13, 95% CI, 0.51-2.53).

Conclusions: Patients with ADRD who are not on anti-dementia drugs are more likely to receive unsatisfactory health care for both Alzheimer's and RD patients. Also, potential health inequities exist in satisfaction with the quality of care. Healthcare providers should take measures to address the unsatisfactory quality of care and related racial disparities for minorities for social justice.