# Barriers to early identification of dementia in a safety net healthcare system

> **NIH NIH R03** · UNIVERSITY OF SOUTHERN CALIFORNIA · 2024 · $165,958

## Abstract

Project Summary
Early identification of cognitive impairment and dementia is associated with multiple public health benefits and
will become even more important if a disease-modifying treatments for Alzheimer’s disease becomes widely
available. However, delayed or missed identification of dementia is common, particularly among racial/ethnic
minorities and those from socioeconomically disadvantaged backgrounds. Possible explanations for this delay
may include patient beliefs about dementia such as it being part of the aging process or fear of associated
stigma; conversely, barriers at the level of provider or health-system may hinder timely diagnostic workup.
The overall goal of this mixed-methods study is to identify barriers to early identification of dementia
for older adults who receive healthcare in a safety net health system. We hypothesize that both patient
and health-system level factors are associated with delay in dementia diagnosis within this patient population.
We will first determine if the decision to seek evaluation for memory symptoms, assessed through hypothetical
clinical scenarios, is associated with a person’s dementia-specific health literacy after adjusting for
demographic factors and health status. We will then evaluate if patient self-report of memory symptoms on a
state-mandated preventive care visit is associated with a higher likelihood of undergoing diagnostic evaluation
for dementia, assessed using a unique electronic health record-derived dataset. We will complement the
analytic aims with semi-structured interviews with patients and caregivers to identify barriers to care for
memory disorders as well as unmet needs.This study will help identify specific barriers that can be targeted for
future interventions to improve early identification of dementia in the safety net population.

## Key facts

- **NIH application ID:** 10913589
- **Project number:** 5R03AG082997-02
- **Recipient organization:** UNIVERSITY OF SOUTHERN CALIFORNIA
- **Principal Investigator:** Elizabeth Bartelt Joe
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $165,958
- **Award type:** 5
- **Project period:** 2023-09-01 → 2026-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10913589

## Citation

> US National Institutes of Health, RePORTER application 10913589, Barriers to early identification of dementia in a safety net healthcare system (5R03AG082997-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10913589. Licensed CC0.

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