Evidence map›Paper›PMID 38415796›Full record

ArticleJournal of the American Geriatrics Society2024

Association between experiencing low healthcare quality and developing dementia.

José M Aravena, Xi Chen, Becca R Levy

Open access · greenAbstract read
In one paragraph

Article in Journal of the American Geriatrics Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
2.7field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 7 citations in OpenAlex.

  1. Designing a communication strategy to promote Alzheimer's disease prevention: The CULTIVAMENTE campaign.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026
    Article
  2. Article
  3. Healthcare inequities and healthcare providers: we are part of the problem.International journal for equity in health · 2025
    Review
  4. Article
  5. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 1 institution in 2 countries.

José M AravenaDepartment of Social & Behavioral Sciences, School of Public Health, Yale University, New Haven, Connecticut, USA.
Xi ChenDepartment of Health Policy and Management, School of Public Health, Yale University, New Haven, Connecticut, USA.ORCID 0000-0002-2058-0351
Becca R LevyDepartment of Social & Behavioral Sciences, School of Public Health, Yale University, New Haven, Connecticut, USA.
Yale University · US

Funding

HRS Yrs29-34: Y33 SSA CoFundingU01AG009740 · NIA · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Jessica Faul, KENNETH M LANGA · 1990 to 2026
$555.8M
Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
Yale Study Support Suite (YES3): Dashboard and Web Portal Software Supporting Research Workflow through integrated, customizable REDCap External ModulesP30AG021342 · NIA · YALE UNIVERSITY · PI Albert C Shaw · 2002 to 2026
$37.9M
Cognitive Resilience among Older SamoansR01AG067533 · NIA · YALE UNIVERSITY · PI LEVY, BECCA R · 2021 to 2025
$4.8M
A Life Course Approach to Understanding Racial and Ethnic Disparities in Alzheimer's Disease and Related Dementias and Health CareR01AG077529 · NIA · YALE UNIVERSITY · PI Xi Chen · 2022 to 2026
$3.6M
Culture-Gene Relationship: A Novel Model of Aging Cognitive HealthU01AG032284 · NIA · YALE UNIVERSITY · PI LEVY, BECCA R · 2017 to 2020
$1.7M
Fulbright and the National Research and Development Agency of Chile (ANID)NCATS NIH HHS UL1 TR001863NIA NIH HHS P30 AG021342NIA NIH HHS P30AG021342NIA NIH HHS R01 AG067533NIA NIH HHS R01AG067533NIA NIH HHS R01 AG077529NIA NIH HHS R01AG077529NIA NIH HHS U01 AG009740NIA NIH HHS U01AG009740NIA NIH HHS U01 AG032284NIA NIH HHS U01AG032284Yale MacMillan Center for International and Area StudiesYale Social and Behavioral Sciences Research FundYale University Council on Latin American and Iberian Studies
6 · The paper itself

Abstract

backgroundLow healthcare quality has been found to predict the development of a number of illnesses in older adults. However, it has not been investigated as a determinant of dementia. Thus, the goal of this study was to assess whether experiencing low healthcare quality is associated with developing dementia in people aged 60 and older.

methodsParticipants in the Health and Retirement Study, without dementia and aged 60 and older at baseline, were followed from 2006 to 2019. Experiencing low healthcare quality was assessed at baseline through questions about healthcare discrimination and dissatisfaction with healthcare services. The outcome, development of new cases of dementia, was determined through physician diagnosis or a cognition score compatible with dementia (assessed by the Telephone Interview for Cognitive Status). Cox regression was used to estimate the hazard ratio (HR) of dementia, adjusting for participants' demographic, health, and socioeconomic factors.

resultsAmong the 3795 participants included in the cohort, 700 developed dementia. Experiencing low healthcare quality was associated with increased dementia risk over 12 years (unadjusted HR: 1.68, 95% CI: 1.27-2.21, p-value <0.001; fully adjusted HR: 1.50, 95% CI: 1.12-2.01, p-value: 0.006). Healthcare discrimination and dissatisfaction with the healthcare quality received were independently associated with increased dementia risk.

conclusionsAs predicted, experiencing low healthcare quality was associated with greater dementia risk. To date, most measures to reduce dementia have focused on individual-level behaviors. Our findings suggest that implementing structural changes to improve healthcare quality delivery for older persons could reduce dementia prevalence.

Indexed as

DementiaQuality of Health CareAgedAged, 80 and overFemaleHumansMaleMiddle AgedRisk Factorsdementiahealthcare quality indicatorspatient satisfactionperceived discriminationsocial determinants of health

Identifiers

PMID38415796
PMCPMC11226361
OpenAlexW4392241195

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.