This paper 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. 

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This systematic review examines interventions designed to reduce inequalities in dementia diagnosis and care. The review highlights that people living with dementia and their carers often face barriers when trying to access services, which can lead to avoidable differences in health outcomes. 

Many of these barriers occur at several levels. Some relate to individual circumstances such as language, cultural background or socioeconomic status. Others occur at community level, for example where stigma around dementia discourages people from seeking help. Structural barriers within health and social care systems also play an important role, particularly where services are fragmented or poorly coordinated. 

The review finds that system-level solutions appear to have the strongest evidence. These include models such as dementia link workers, integrated care networks and memory clinic collaborations. These approaches can improve coordination between services and help individuals and carers access appropriate support more easily. In some studies, link worker roles also improved quality of life for people living with dementia and reduced pressure on carers. 

Community-level initiatives can also play an important role. Programmes that raise awareness about dementia, reduce stigma and build dementia-friendly communities may encourage earlier help-seeking and improve understanding of the condition. Culturally tailored information and support programmes can also help address barriers faced by minority ethnic communities. 

The review also identifies increasing use of digital tools to support dementia care. Online information platforms, telehealth services and digital care planning tools can help some people access support more easily. However, the authors note that digital solutions can also create new barriers where people lack digital skills, access to technology or reliable internet connections. 

From a health and social care equity perspective, the findings show that inequities in dementia care often arise from structural barriers within systems rather than individual choices. Access to diagnosis, information and support can vary depending on geography, service availability and socioeconomic circumstances.

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. 

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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. 

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This paper examines how dementia services in the UK fail to meet the needs of Black and minoritised communities, despite longstanding policy commitments to inclusion. It shows a clear gap between national ambitions and what is delivered locally. 

A key issue is late access to care. Many individuals from these communities only engage with services at crisis point, which limits access to early diagnosis, treatment and support that could improve quality of life. 

Barriers are multiple and intersecting. These include limited awareness of dementia, language and literacy challenges, and difficulty navigating complex health and social care systems. Cultural expectations around family care also shape help-seeking, particularly where services are not seen as culturally appropriate. 

The study also highlights the role of structural factors. Experiences of racism and discrimination, alongside a lack of culturally competent services, contribute to mistrust and disengagement. At the same time, people from these communities are more likely to experience wider socio-economic disadvantage, which increases dementia risk over the life course. 

Policy frameworks such as the National Dementia Strategy emphasise inclusive and person-centred care. However, the decentralised nature of commissioning means that implementation varies widely. This creates geographical inequities, with some areas offering tailored services while others provide little targeted support. 

From a care equity perspective, the findings show that inequities are present across the entire dementia pathway, from prevention and diagnosis through to end-of-life care. Without stronger accountability and culturally appropriate service design, these disparities are likely to persist.

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This study highlights inequities in access to social care and carers’ needs assessments for people with dementia and unpaid carers. Lack of awareness about entitlements and complex systems mean that support needs often go unidentified or unmet.

Barriers are reinforced by system pressures. Professionals conducting assessments face time and resource constraints, which can limit the depth and effectiveness of assessment processes.

The persistence of unmet needs after assessment points to wider structural issues. Fragmented coordination between health and social care services reduces the likelihood that identified needs translate into practical support.

From a care equity perspective, improving awareness, accessibility and integration is central to ensuring that carers and people with dementia receive support based on need rather than ability to navigate complex systems. Without addressing these barriers, existing inequalities in access and outcomes are likely to continue.

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This study highlights the complex role of assistive technology in home-based dementia care. Carers often assemble multiple technologies to manage safety and daily support, reflecting both the potential value and the burden of technology use.

From a care equity perspective, information and affordability barriers are central. Carers with less access to advice or financial resources may struggle to identify suitable technologies or sustain their use as needs evolve.

The frequent abandonment of technologies underscores the importance of adaptability. Static solutions are poorly suited to the progressive nature of dementia, placing additional emotional and practical strain on carers.

Overall, the findings reinforce that the use of technology in care must be supported by clear information, ongoing advice and flexible provision. Without this, assistive technology risks increasing burden rather than supporting carers and the people they care for.

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This study illustrates how the digitalisation of financial management brings mixed consequences for people living with dementia and those who support them. While automated payments and card-based systems can reduce day-to-day burden, they can also obscure oversight and increase dependence on others.

The findings show that digital change often shifts responsibility rather than removing it. As systems become harder to navigate, unpaid carers frequently absorb additional financial tasks, adding to existing caring pressures. These dynamics are particularly pronounced where platforms are not designed with cognitive impairment in mind.

Usability emerges as a central issue. Digital finance tools that assume high levels of confidence, memory and comprehension can inadvertently exclude people living with dementia, even when intended to simplify processes.

Overall, the study highlights the need to treat financial digitalisation as part of care infrastructure. Ensuring that systems are accessible, supported and adaptable is essential if technology is to reduce burden rather than redistribute it onto carers.

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This NIHR trial provides some of the strongest evidence on the limits of telecare effectiveness in dementia care. By comparing a comprehensive telecare package with a basic offer, it challenges assumptions that more technology necessarily leads to better outcomes.

From a care equity standpoint, the findings highlight risks in technology-led approaches that do not account for individual context. Standardised packages may fail to support people with dementia whose needs, capabilities and environments vary widely.

The results align with qualitative evidence showing that personalisation, support and fit with daily life are critical to successful technology use. Without these elements, telecare may add complexity without delivering meaningful benefit.

Overall, the study highlights that the use of technology in care must be grounded in person-centred assessment and ongoing support. Technology alone is insufficient to improve outcomes, and poorly matched interventions risk diverting resources from more effective forms of care.

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This study provides rich insight into how assistive technology is used in real-world dementia care. Rather than being passively adopted, technologies are actively adapted, modified or abandoned depending on how well they fit with everyday routines and relationships.

From a care equity viewpoint, the findings challenge assumptions that technology alone can provide support. Without tailoring, ongoing support and responsiveness to changing needs, assistive technologies may fail to deliver intended benefits and can even create new burdens.

The concept of ‘bricolage’ highlights the work done by carers to make technologies usable. This ‘invisible work’ is rarely recognised in service design or commissioning, yet it is central to whether technology supports or disrupts care.

Overall, the study stresses that the use of technology in care must be grounded in lived experience. Personalisation, flexibility and longitudinal support are essential if assistive technology is to support people with dementia and their carers equitably and sustainably.

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This study provides insight into how technology is woven into everyday life within supported living environments for people with dementia. Rather than being experienced as purely clinical tools, technologies such as wearables and mobile phones were often described as contributing to reassurance and a sense of security.

The findings also show that technology use is relational. Tenants’ ability to benefit depended on the support of both informal and formal carers, alongside opportunities to build digital confidence. Where this support was available, technology was more likely to be used in ways that aligned with residents’ preferences.

At the same time, the study highlights ethical tensions. Monitoring and assistive technologies raised questions about privacy, consent and autonomy, particularly as cognitive capacity changes over time. These concerns highlight the importance of clear governance and ongoing dialogue with tenants and carers.

Overall, the research suggests that technology can enhance supported living when it is thoughtfully integrated into care models. Ensuring that use remains person-centred, ethically grounded and supported over time is central to avoiding harm and enabling technology to contribute positively to dementia care.

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These studies highlight consistent barriers to accessing dementia care across European settings, particularly for underserved populations. A key finding is that receiving a diagnosis does not guarantee access to appropriate support, with many individuals and carers facing ongoing challenges navigating complex and fragmented systems. 

A dominant theme across both studies is lack of awareness. Individuals often do not know what services are available or how to access them, and in many cases must actively search for support themselves. This creates an access barrier that disproportionately affects those with lower health literacy or fewer resources. 

System fragmentation further compounds these issues. The absence of a single point of contact or care coordinator means that individuals and carers are required to navigate multiple services independently. Evidence from the Netherlands suggests that having a care navigator can improve access, highlighting a potential model for wider implementation. 

Cultural and language barriers are also significant. People from minority ethnic backgrounds may face additional stigma, lack of culturally appropriate services and difficulties accessing information, contributing to lower service use. These factors illustrate how structural inequalities translate into inequities in access to care. 

Financial barriers are another key issue. Many services require partial or full self-funding, which limits access for those with fewer financial resources. This reinforces existing socio-economic inequalities and aligns with broader patterns seen in social care access. 

From a care equity perspective, these findings show how multiple barriers interact. Factors such as geography, culture, income and system design combine to shape access to dementia care. Without targeted policy action, these inequities are likely to persist, particularly for underserved groups who already face disadvantages in accessing support. 

Overall, the evidence suggests that improving dementia care access requires coordinated system-level change, alongside culturally sensitive and financially accessible services.