Dementia Diagnostic Deserts: Workforce and Geographic Inequities in the Diagnostic Pathway for Cognitive Impairment

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Describes the "Triple Disadvantage Zones" or the places where rurality, Primary Care Health Professional Shortage Areas, and social deprivation converge to create a dementia diagnostic desert resulting in both delayed diagnosis and over-testing. Discusses training gaps for nurse practitioners and physician assistants as well as policy measures to mitigate diagnosis errors.

Zhijung Xu, Ying Xue, Yaguang Zheng, Bei Wu

Health Affairs Scholar, 4(5)

05/2026

Dementia · Health disparities · Health screening · Health workforce education and training · Health workforce shortage designations · Healthcare quality · Nurse practitioners and other advanced practice registered nurses · Physician assistants · Policy