Mind the Gap: Dementia in underrepresented populations

Dementia services have increasingly focused on diagnosis, earlier identification, shorter waiting times and, more recently, disease-modifying treatments for Alzheimer’s disease. Debate about the clinical benefits and cost-effectiveness of anti-amyloid therapies, alongside decisions about NHS access, has attracted considerable attention from charities, campaign groups and the media. These developments may offer benefits to some people living with dementia, but they do not resolve the inequalities experienced by the underserved and underrepresented communities. This commentary argues that a narrow emphasis on diagnosis rates, waiting times and access to new treatments risks leaving longstanding gaps in dementia assessment, post-diagnostic support and care less visible. We consider the experiences of ethnic minority communities, socioeconomically deprived populations, LGBTQ+ people, migrants and refugees, people with intellectual disabilities, Gypsy and Traveller communities, people in prisons, and neurodivergent people. We argue that service improvement should combine timely diagnosis and access to effective treatments with culturally responsive care, inclusive research, better data collection and meaningful measures of equity.