Episode 7: Bridging Gaps in Dementia Care

Andie Cartwright

Hi everyone, welcome back to Better Living Through Data. I’m Andie Cartwright, and I’ve got Anthony Pero here with me today. We’re diving into the complex world of dementia care, especially focusing on treatment patterns in long-term care. Anthony, I think we’ve both seen how much the data landscape has shifted lately?

Anthony Pero

Absolutely, Andie. You know, what’s striking is that, according to this latest PointClickCare-linked study, nearly three-quarters—72.5%—of residents with Alzheimer’s and related dementias in long-term care actually receive at least one of the recommended pharmacologic treatments. I mean, that’s a solid majority, but when you flip it around, it means more than a quarter of residents don’t get these therapies at all.

Andie Cartwright

Right, and when you dig into the numbers, the rates really aren’t the same across the board. You have Lewy body dementia at the top, with 83.9% of those residents treated, and early-onset Alzheimer’s close behind at 82.3%. So, some subtypes are getting more attention, maybe because they manifest differently or respond to therapy in noticeable ways?

Anthony Pero

Yeah, but then you look at the other end, right? Residents 90 years or older only see 65.1% treated, and Black or African American residents, that’s even lower, at 66.8%. And for folks with cerebral degeneration, it’s about the same—66.8%. I remember back when I was at Independence Blue Cross, this sort of pattern showed up all the time. Clinical teams would do everything they could, but practical barriers just kept popping up—like challenges getting certain meds cleared, or even basic issues like timing and communication with families. Where was I going with that? Oh, the barriers just accumulate.

Andie Cartwright

No, that makes total sense, Anthony. And it echoes what we talked about in episode three, how there are these systemic barriers—sometimes it's policy, sometimes it's just fragmented communication. Even with a majority getting some treatment, there's this real concern for those left out or facing different odds depending on their background, diagnosis, or even just the facility they’re in.

Anthony Pero

Exactly. And it’s not always for lack of trying. Sometimes, despite clinical guidelines, residents slip through the cracks. That’s the heart of what makes these findings both validating for what teams already know anecdotally and kind of urgent—because they tell us where those cracks really are.

Andie Cartwright

So, building on that—let’s talk about what shapes those gaps. The study shows that both demographics and clinical factors play a big role in who gets treatment. For instance, having diabetes or hyperlipidemia made residents less likely to receive therapy. I’m always a little surprised by that—do clinicians see it as a risk to pile on another med, or is it just clinical inertia?

Anthony Pero

It could be a bit of both. There’s the concern about interactions and overall pill burden, definitely. But what really stands out is how non-clinical factors—like age, race, and especially the dementia subtype—are strong predictors of whether someone gets treated. That treatment rate for Black or African American residents, sitting at 66.8%, really raises red flags for me. And it’s not like the disease itself is picking favorites—it’s the system reacting differently based on factors that shouldn’t matter. We keep seeing that over and over, don’t we?

Andie Cartwright

We absolutely do. And honestly, it reminds me of a campaign I worked on a couple years ago targeting preventive care in underrepresented communities. We had to completely rethink language, imagery, outreach—nothing generic worked. The same story applies here: unless we deliberately design interventions with these disparities in mind, things just don’t get better. This study shines a big spotlight on who’s left behind and, in a weird way, gives us a starting point to do better.

Anthony Pero

Yeah, and it goes back to something we keep bringing up on this podcast—real-world data helps us put actual numbers to things people have sensed for years. This isn’t just a bunch of abstract statistics; it’s people not getting needed therapy because of factors that shouldn’t affect their care. I mean, if we’re talking about improving outcomes on a population level, this is where we need to focus energy, right?

Andie Cartwright

Right. It’s another reminder that in spite of newer guidelines; treatment patterns vary significantly. And, I might be wrong about this, but I feel like the only way to move forward is to acknowledge and aggressively address those influencing factors at every step, from facility policy on up to national protocols.

Andie Cartwright

And this brings us to something we can’t ignore when talking about dementia care—polypharmacy. The data show that treated residents averaged 4.4 meds compared to 3.3 for untreated. That’s a pretty big difference, especially since we know these folks are already vulnerable to side effects. Anthony, this really brings up some tough questions, doesn’t it?

Anthony Pero

Definitely. You pile on more meds, and suddenly you’re looking at a whole new risk for adverse effects or drug interactions—especially in older adults. What’s wild to me is, despite all this prescribing, over a quarter of residents go untreated with the therapies that are supposed to help. And on top of that, the current treatment options aren’t all that effective and can come with a lot of side effects. Like, are we really moving the needle for these people?

Andie Cartwright

Yeah, exactly. It just feels like we’re stuck sometimes—balancing between too many medications and not enough options that actually make a difference. The study’s findings are a wake-up call to urgently develop new therapies and really rethink how we manage the ones we do have. And—sorry, minor tangent, but—we talked last episode about how real-world data can drive course corrections, right? That could be huge for medication management here.

Anthony Pero

Oh, totally. And at PCC Life Sciences, that’s what we’re trying to enable—supporting care teams with more data about actual medication patterns so they can recognize polypharmacy risks sooner. The more insights we get about who’s being treated, how, and with what outcomes, the more we can push for clinical innovation versus just doing the same thing over and over. And, well, hopefully get us closer to personalized, safer care for residents.

Andie Cartwright

Couldn’t agree more. There’s a lot of work ahead, but at least these kinds of studies put the problems into clear focus. That’s all the time we have for today. Anthony, thanks for being here and bringing your perspective—it’s always a pleasure.

Anthony Pero

Thanks, Andie, always great to dig into this with you. Appreciate all the listeners joining us too.

Andie Cartwright

We’ll be back soon with more data-driven conversations to move care forward. Take care, everyone!