Addressing inequalities in dementia diagnosis and care 

This study uses the term inequalities. In this Evidence Hub, inequities is used where differences in access or outcomes reflect avoidable and unfair structural barriers in health and social care. 

Key messages 

• people with dementia and their carers experience multiple inequalities affecting diagnosis, access to care and support 

• these inequalities arise across three levels: individual characteristics, community and social networks, and wider societal and system factors 

• stakeholders identified a range of potential solutions focused on strengthening community support and improving health and social care services 

• proposed interventions included dementia link workers, improved workforce training, community awareness programmes and culturally appropriate services 

• stakeholders emphasised that no single intervention can address inequalities in dementia care and that coordinated actions are needed across multiple levels 

• improving integration between health and social care services is essential to support people after diagnosis 

• increasing public awareness and reducing stigma were identified as priorities for improving help-seeking and earlier diagnosis 

Policy implications 

• develop link worker or care navigator roles to help individuals and carers navigate services and support after diagnosis 

• improve integration and communication between health and social care services 

• increase workforce training to improve dementia knowledge across health and social care settings 

• create clearer career pathways within the social care workforce to support recruitment and retention 

• expand community awareness programmes and dementia-friendly initiatives 

• improve culturally appropriate services and accessible information for diverse communities 

• strengthen national coordination and accountability to reduce regional variation in dementia care 

Gaps 

• the proposed solutions were identified through consultation and require further evaluation to assess effectiveness 
• people living with dementia were less represented than carers and professionals in the workshops 
• some demographic groups were under-represented in the consultation process 

• there is limited evidence on the long-term impact of many proposed interventions 

• further research is needed to evaluate the cost-effectiveness and scalability of suggested solutions 

Commentary 
This study explores practical ways to address inequalities in dementia diagnosis and care through a national consultation involving people with dementia, carers, professionals and community organisations. The consultation involved 131 stakeholders who participated in workshops across England to discuss the barriers people face and identify possible solutions. 

The findings show that inequalities in dementia care arise from multiple interacting factors. These include individual circumstances such as income or ethnicity, community-level influences such as stigma or limited social support, and wider structural issues such as service availability and coordination between health and social care systems. 

Many of the proposed solutions focused on improving support after diagnosis. Stakeholders highlighted the potential role of dementia link workers or care navigators who could help people and their families understand their diagnosis, navigate services and access appropriate support. These roles could help address some of the structural barriers that currently create inequities in access to care. 

Community engagement was also identified as important. Participants emphasised the role of dementia-friendly communities, peer networks and local organisations in raising awareness and reducing stigma. Improving understanding of dementia within communities may encourage earlier help-seeking and improve access to support. 

Workforce development was another key theme. Stakeholders identified the need for better training for health and social care professionals, as well as clearer career pathways within the social care workforce. Improving workforce knowledge and stability may help reduce inequities in the quality and availability of dementia services. 

From a care equity perspective, the study highlights that inequalities in dementia care often reflect avoidable structural barriers within systems and services. These inequities can affect who receives a diagnosis, how quickly support is provided and the quality of care available after diagnosis. 

Overall, the study suggests that reducing inequities in dementia care requires coordinated action across multiple levels. Interventions targeting individuals, communities and health and social care systems need to work together to ensure that people living with dementia can access timely diagnosis and appropriate support regardless of their background or location.