Ethnic disparity in access to the memory assessment service between South Asian and white British older adults in the United Kingdom: A cohort study

Ogliari, Giulia; Turner, Zoe; Khalique, Javid; Gordon, Adam L.; Gladman, John R. F.; Chadborn, Neil H.

Abstract

Background: Equality of access to memory assessment services by older adults from ethnic minorities is both an ethical imperative and a public health priority.
Objective: To investigate whether timeliness of access to memory assessment service differs between older people of White British and South Asian ethnicity.
Design: Longitudinal cohort.
Setting: Nottingham Memory Study; outpatient secondary mental healthcare.
Subjects: Our cohort comprised 3,654 White British and 32 South Asian older outpatients.
Methods: The criterion for timely access to memory assessment service was set at 90 days from referral. Relationships between ethnicity and likelihood of timely access to memory assessment service were analysed using binary logistic regression. Analyses were adjusted for socio-demographic factors, deprivation and previous access to rapid response mental health services.
Results: Among White British outpatients, 2,272 people (62.2%) achieved timely access to memory assessment service. Among South Asian outpatients, fourteen people (43.8%) achieved timely access to memory assessment service. After full adjustment, South Asian outpatients had a 0.47-fold reduced likelihood of timely access, compared to White British outpatients (odds ratio 0.47, 95% confidence interval 0.23-0.95, p-value=0.035). The difference became non-significant when restricting analyses to outpatients reporting British nationality or English as first language. Older age, lower index of deprivation and previous access to rapid response mental health services were associated with reduced likelihood of timely access, while gender was not.
Conclusions: In a UK mental healthcare service, older South Asian outpatients are less likely to access dementia diagnostic services in a timely way, compared to White British outpatients.

Citation

Ogliari, G., Turner, Z., Khalique, J., Gordon, A. L., Gladman, J. R. F., & Chadborn, N. H. (2020). Ethnic disparity in access to the memory assessment service between South Asian and white British older adults in the United Kingdom: A cohort study. International Journal of Geriatric Psychiatry, 35(5), 507-515. https://doi.org/10.1002/gps.5263

• Journal Article Type: Article
• Acceptance Date: Dec 23, 2019
• Online Publication Date: Jan 13, 2020
• Publication Date: 2020-05
• Deposit Date: Jan 24, 2022
• Publicly Available Date: Jan 24, 2022
• Journal: International Journal of Geriatric Psychiatry
• Print ISSN: 0885-6230
• Electronic ISSN: 1099-1166
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 35
• Issue: 5
• Pages: 507-515
• DOI: https://doi.org/10.1002/gps.5263
• Keywords: Psychiatry and Mental health; Geriatrics and Gerontology
• Public URL: https://nottingham-repository.worktribe.com/output/3656125
• Publisher URL: https://onlinelibrary.wiley.com/doi/10.1002/gps.5263
• Additional Information: This is the peer reviewed version of the following article: Ogliari, G, Turner, Z, Khalique, J, Gordon, AL, Gladman, JRF, Chadborn, NH. Ethnic disparity in access to the memory assessment service between South Asian and white British older adults in the United Kingdom: A cohort study. Int J Geriatr Psychiatry. 2020; 35: 507– 515., which has been published in final form at https://doi.org/10.1002/gps.5263. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.