A new study has found major differences in dementia care that people in richer and poorer neighborhoods have received in Quebec, despite the universal health care system.
The research was led by Dr. Claire Godard-Sebillotte, a professor at the Division Geriatrics from McGill University and a researcher at the Research Institute of the McGill University Health Center. It is the first large -scale study in Quebec to keep track of how social circumstances relate to dementia care.
The study analyzed health files of around 200,000 people who were newly diagnosed with dementia between 2000 and 2017. Each patient was followed for a year or until his death or admission to a long -term care institution, depending on what happened for the first time. To measure socio-economic status, the researchers used a standard material deprivation index, which ranks neighborhoods on the basis of income, education and employment level.
People in the most disadvantaged areas were more likely than people in the least disadvantaged areas who had to be admitted to the hospital, visit first aid, receive potentially inappropriate medicines and die within a year after diagnosis. In the meantime, people in richer neighborhoods had more visits to cognition specialists.
Healthcare differences in context
Because of lifelong disadvantages, people in poorer areas can be in poorer health by the time they have diagnosed dementia, which could partially explain why they trust more in hospitals and die more within the year of diagnosis. However, this raises questions about fairness within our universal health care system, said Godard-Sebillotte.
The persistence of these patterns for almost two decades of data is worrying. Access to care must be adapted to the needs of people. Equity is not going to treat everyone the same, it is about ensuring that every person receives the right care for his situation. “
Dr. Claire Godard-Sebillotte, Professor in the Geriatrics division of McGill University
People in poorer neighborhoods were more often prescribed medicines such as antipsychotics or benzodiazepines, which can increase the risk of falling and can increase confusion. They also had less chance of seeing cognition specialists.
“This result indicates inequality. Indeed, if people in poorer neighborhoods had consistently had more complex health needs that require these potentially inappropriate drugs, they must be referred more to cognition specialists. It is possible that people in these areas are actually not more complex, but have less access to home care or other support for care providers.
Use data to stimulate change
As one of the directors of the research into the organization of healthcare services for the Alzheimer’s team, Godard-Sebillotte and her colleagues work closely with the Minister of Health of Quebec to share their findings and to support evidence-based decision-making.
The insights of the study have informed the Quebec policy about Alzheimer’s disease and other neurocognitive disorders that, in contrast to most policy, include an isolated objective to reduce inequality in dementia care.
Subsequently, the research team is planning to investigate how racialization, language and life in rural areas cross each other with poverty to shape the access of people to care.
About the study
“Investigating fairness in service consumption about the socio-economic status in people with dementia” by Claire Godard-Sebillotte and Isabelle Vedel et al., Was published in Alzheimer and dementia: behavior and socio -economy of aging.
This study was supported by the Canadian consortium on neurodegeneration in aging.
Source:
Journal Reference:
Godard -Sebillotte, c ,, et al .. (2025). Research into equity in service use about socio -economic status in people with dementia. Alzheimer’s and Dementia: Behavior Behavior and Social Economics. doi.org/10.1002/BSA3.70006.