Missed and Delayed Diagnosis of Dementia in Primary Care: Prevalence and Contributing Factors
By A. Bradford, Mark E. Kunik, Paul E. Schulz, Susan P. Williams, Hardeep Singh. Alzheimer Disease and Associated Disorders, 2009
902 citations recorded by the source corpus.
Dementia is a growing public health problem for which early detection may be beneficial. Currently, the diagnosis of dementia in primary care is dependent mostly on clinical suspicion on the basis of patient symptoms or caregivers' concerns and is prone to be missed or delayed. We conducted a systematic review of the literature to ascertain the prevalence and contributing factors for missed and delayed dementia diagnoses in primary care. Prevalence of missed and delayed diagnosis was estimated by abstracting quantitative data from studies of diagnostic sensitivity among primary care providers. Possible predictors and contributory factors were determined from the text of quantitative and qualitative studies of patient, caregiver, provider, and system-related barriers. Overall estimates of diagnostic sensitivity varied among studies and seemed to be in part a function of dementia severity, degree of patient impairment, dementia subtype, and frequency of patient-provider contact. Major contributory factors included problems with attitudes and patient-provider communication, educational deficits, and system resource constraints. The true prevalence of missed and delayed diagnoses of dementia is unknown but seems to be high. Until the case for dementia screening becomes more compelling, efforts to promote timely detection should focus on removing barriers to diagnosis.
Subfields: Family Practice, General Health Professions, Philosophy
View Paper: https://www.semanticscholar.org/paper/05e3df342cedfae897d8930d09199b248dabfae4
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Citations in the corpus
- Alzheimer disease in the United States (2010–2050) estimated using the 2010 census (2013, methodology): “This is preferable to using clinical sources because many people who have AD dementia are not clinically diagnosed.(20) Moreover, CHAP’s approach to diagnosis included evaluation of people from all strata of cognitive performance, including the best performers, which prevented undercounting new case”