Do Māori and Pacific Peoples Living with Dementia in New Zealand Receive Equitable Long-Term Care Compared with New Zealand Europeans?

Ma’u, Etuini; Saeed, Fady; Yates, Susan; Oulaghan, Bede; Whittington, Rosie; Coomarasamy, Christin; Cheung, Gary; Cullum, Sarah

doi:10.31389/jltc.148

Cited by 8 publications

(9 citation statements)

References 23 publications

(31 reference statements)

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“…aDementia prevalence in European countries based on Dementia in Europe Yearbook – 2012 [41] | Dementia prevalence in Australia based on the Dementia in Australia Report 2021 [42] | Dementia prevalence in New Zealand based on the national Dementia Economic Impact Report – 2020 [43].bFrom unpublished work submitted to BMC Geriatrics.…”

Section: What Is a Memory Clinic?mentioning

confidence: 99%

The role of Memory Clinics in the assessment and management of dementia, now and into the future

Mehrani

Sachdev

2022

Current Opinion in Psychiatry

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Purpose of reviewThe diagnosis of dementia is often delayed and many individuals with the disorder go undiagnosed or receive an inadequate assessment. Specialist Memory Clinics have long been at the centre of such assessments. Recent developments in biomarkers and disease-modifying treatments are likely increase the need for specialist assessments. It is therefore timely to review the role of Memory Clinics internationally. Recent findingsThe timely diagnosis of dementia and cognitive decline is the main responsibility of Memory Clinics. These clinics can diagnose dementia up to 4 years earlier than primary care services, but their low numbers and capacity of leads to long waiting times and a focus on complex cases. Few clinics are resourced to offer specific postdiagnostic support services, and their roles in clinical trials and research have not been realised. They are often well integrated with primary care and aged care services. SummaryMemory Clinics play an important role in bridging the gap between research and clinical practice and providing high-quality assessment and care. Additional Memory Clinic services and greater harmonisation of their responsibilities and procedures are needed to exploit their full potential.

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Section: What Is a Memory Clinic?mentioning

confidence: 99%

The role of Memory Clinics in the assessment and management of dementia, now and into the future

Mehrani

Sachdev

2022

Current Opinion in Psychiatry

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“…In New Zealand, an estimated 1 in 50 people aged between 60 and 64 years have a diagnosis of dementia, rising to 1 in 8 of those aged between 80 and 84 years (Cheung et al, 2022; Ma’u et al, 2021b). Globally, it is estimated that there are currently more than 50 million people living with dementia, with these numbers projected to double in the next 20 years (Prince et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

“…Where an individual identifies as more than one ethnicity, prioritised ethnicity is used, that is, individuals are classified into one ethnic group, in the following prioritised order: Māori, Pacific Peoples, Asian, MELAA, Other and European (Boven et al, 2020). As the Dementia Economic Impact Report 2020 identified there is inequity in dementia care across the main ethnic groups in New Zealand (Ma’u et al, 2021b), we hypothesised that the rates of anti-dementia medication use are likely to be different among the main ethnic groups.…”

Section: Introductionmentioning

confidence: 99%

Anti-dementia medication use in Aotearoa New Zealand: An exploratory study using health data from the Integrated Data Infrastructure (IDI)

Chan

Hikaka

et al. 2022

Aust N Z J Psychiatry

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Objective: Anti-dementia medications such as acetylcholinesterase inhibitors are an important part of the management pathway for dementia. However, there are limited data in New Zealand that have examined the rates and patterns of use of funded anti-dementia medication and how use differs with ethnicity, age and sex. Methods: This was a retrospective population-based descriptive study. Using the Integrated Data Infrastructure, we identified individuals of all ages coded for a diagnosis of dementia and estimated the proportion dispensed funded anti-dementia medication – donepezil tablets and rivastigmine patches – between 1 July 2016 and 30 June 2020. Rates of medication use in five main ethnic groups (Māori, Pacific peoples, Asian, European, and Middle Eastern, Latin American and African) in the <65, 65–79 and 80 and over (80+) age groups were compared and also between males and females in all sub-groups. Log-binomial models were used to calculate relative risks to determine any differences in anti-dementia medication use in the five ethnic groups and the three age groups and between males and females in each of the four study years. Results: Overall, one-third of the dementia population received a funded anti-dementia medication in the total population (all ages) between 2016 and 2020. Donepezil tablets were dispensed in 31.6–34.0% and rivastigmine patches in 1.4–2.1% across the four study years. Compared to people of European ethnicity, Māori, Pacific peoples, and Middle Eastern, Latin American and African groups were less likely to be dispensed an anti-dementia medication (Māori: relative risk = 0.79–0.81, p < 0.0001; Pacific peoples: relative risk = 0.72–0.74, p < 0.0001; Middle Eastern, Latin American and African: relative risk = 0.73–0.78, p < 0.05). Compared to the age 80+ group, the 65–79 age group was more likely (relative risk = 1.50–1.54, p < 0.0001), while the age <65 group was less likely (relative risk = 0.67–0.71, p < 0.0001) to be dispensed an anti-dementia medication. There were no statistically significant differences in anti-dementia medication use between males and females. Conclusion: This study provides important information about funded anti-dementia medication use in New Zealand and how this differs by ethnicity, age and sex. Despite higher dementia prevalence in Māori and Pacific peoples, these groups were less likely to receive funded anti-dementia medication.

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“…This will further strain an already stretched public health system and place increasing burden on people living with dementia and their family and carers. There is also evidence that this burden is inequitably borne by Māori, the indigenous people of New Zealand, and non-European ethnic minorities (Ma’u E, 2021b).…”

mentioning

confidence: 99%

“…Most current post-diagnostic supports and services are designed for New Zealand Europeans who have made up the overwhelming majority of dementia cases. It is perhaps not surprising then that current dementia service provision is generally not seen as fit for purpose by non-European populations, with subsequent lower uptake of funded social services including home-based supports and aged residential care (Figure 2) (Ma’u E, 2021b).…”

mentioning

confidence: 99%

Navigating ethnic diversity: Rethinking dementia prevention in Aotearoa New Zealand

Ma’u,

Cullum,

Cheung

2024

Aust N Z J Psychiatry

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Do Māori and Pacific Peoples Living with Dementia in New Zealand Receive Equitable Long-Term Care Compared with New Zealand Europeans?

Cited by 8 publications

References 23 publications

The role of Memory Clinics in the assessment and management of dementia, now and into the future

The role of Memory Clinics in the assessment and management of dementia, now and into the future

Anti-dementia medication use in Aotearoa New Zealand: An exploratory study using health data from the Integrated Data Infrastructure (IDI)

Navigating ethnic diversity: Rethinking dementia prevention in Aotearoa New Zealand

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