# Healthcare Utilization Disparities Among Older Adults With and Without Cognitive Impairment: Health and Retirement Study Findings

## TL;DR

This study finds that older adults with and without cognitive impairment use healthcare services differently based on factors like race, gender, and education.

## Contribution

The study reveals disparities in healthcare utilization among older adults with and without cognitive impairment, stratified by demographic factors.

## Key findings

- Hispanics with normal cognition are less likely to stay in a hospital compared to non-Hispanic individuals.
- Being female is associated with more doctor visits and shorter nursing home stays for cognitively normal older adults.
- Black respondents with dementia are less likely to experience nursing home days compared to other groups.

## Abstract

The purpose of this study was to determine the healthcare utilization patterns in a national sample of older adults across several factors (ethnicity, gender, race, education) with normal and dementia/impaired cognition. We used datasets from the Health and Retirement Study (HRS, 2018) to evaluate healthcare utilization, including metrics such as hospital and nursing home stays, hospice care, and the number of visits to the doctor. Logistic models were used to predict healthcare utilization separately in those with normal cognition and dementia. Our final sample comprised 15,607 adults (mean age: 65.2 normal cognition, mean age 71.5 dementia). Hispanics with normal cognition were less likely to stay in a hospital than non-Hispanic respondents (OR: 0.52–0.71, p < 0.01). Being female was associated with a higher risk for shorter nursing home days (OR: 1.41, p < 0.01) and doctor visits (OR: 1.63–2, p < 0.01) in cognitively normal older adults. Being female was associated with a lower risk for hospital stay in those with dementia (OR: 0.50–0.78, p < 0.01). Respondents identifying as Black or other races with dementia were less likely to experience nursing home days (OR: 0.42, p < 0.04). Black respondents with normal cognition were less likely to experience doctor visits (OR: 0.32–0.37, p < 0.01). Those with more than a high school education in both groups were more likely to experience doctors’ visits. The study points to the continued disparities in healthcare utilization linked to participants’ characteristics and cognition.