Prevalence and determinants of undetected dementia in the community: a systematic literature review and a meta-analysis

2.50
Hdl Handle:
http://hdl.handle.net/2436/620516
Title:
Prevalence and determinants of undetected dementia in the community: a systematic literature review and a meta-analysis
Authors:
Lang, Linda; Clifford, Angela; Wei, Li; Zhang, Dongmei; Leung, Daryl; Augustine, Glenda; Danat, Isaac M; Zhou, Weiju; Copeland, John R; Anstey, Kaarin J; Chen, Ruoling
Abstract:
Objectives Detection of dementia is essential for improving the lives of patients but the extent of underdetection worldwide and its causes are not known. This study aimed to quantify the prevalence of undetected dementia and to examine its correlates. Methods/setting/participants A systematic search was conducted until October 2016 for studies reporting the proportion of undetected dementia and/or its determinants in either the community or in residential care settings worldwide. Random-effects models calculated the pooled rate of undetected dementia and subgroup analyses were conducted to identify determinants of the variation. Primary and secondary outcome measures The outcome measures of interest were the prevalence and determinants of undetected dementia. Results 23 studies were eligible for inclusion in this review. The pooled rate of undetected dementia was 61.7% (95% CI 55.0% to 68.0%). The rate of underdetection was higher in China and India (vs Europe and North America), in the community setting (vs residential/nursing care), age of <70 years, male gender and diagnosis by general practitioner. However, it was lower in the studies using Mini-Mental State Examination (MMSE) diagnosis criteria. Conclusions The prevalence of undetected dementia is high globally. Wide variations in detecting dementia need to be urgently examined, particularly in populations with low socioeconomic status. Efforts are required to reduce diagnostic inequality and to improve early diagnosis in the community.
Citation:
Prevalence and determinants of undetected dementia in the community: a systematic literature review and a meta-analysis 2017, 7 (2):e011146 BMJ Open
Publisher:
BMJ Open
Journal:
BMJ Open
Issue Date:
3-Feb-2017
URI:
http://hdl.handle.net/2436/620516
DOI:
10.1136/bmjopen-2016-011146
Additional Links:
http://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2016-011146
Type:
Article
Language:
en
ISSN:
2044-6055
Appears in Collections:
FEHW

Full metadata record

DC FieldValue Language
dc.contributor.authorLang, Lindaen
dc.contributor.authorClifford, Angelaen
dc.contributor.authorWei, Lien
dc.contributor.authorZhang, Dongmeien
dc.contributor.authorLeung, Darylen
dc.contributor.authorAugustine, Glendaen
dc.contributor.authorDanat, Isaac Men
dc.contributor.authorZhou, Weijuen
dc.contributor.authorCopeland, John Ren
dc.contributor.authorAnstey, Kaarin Jen
dc.contributor.authorChen, Ruolingen
dc.date.accessioned2017-06-14T14:39:14Z-
dc.date.available2017-06-14T14:39:14Z-
dc.date.issued2017-02-03-
dc.identifier.citationPrevalence and determinants of undetected dementia in the community: a systematic literature review and a meta-analysis 2017, 7 (2):e011146 BMJ Openen
dc.identifier.issn2044-6055en
dc.identifier.doi10.1136/bmjopen-2016-011146-
dc.identifier.urihttp://hdl.handle.net/2436/620516-
dc.description.abstractObjectives Detection of dementia is essential for improving the lives of patients but the extent of underdetection worldwide and its causes are not known. This study aimed to quantify the prevalence of undetected dementia and to examine its correlates. Methods/setting/participants A systematic search was conducted until October 2016 for studies reporting the proportion of undetected dementia and/or its determinants in either the community or in residential care settings worldwide. Random-effects models calculated the pooled rate of undetected dementia and subgroup analyses were conducted to identify determinants of the variation. Primary and secondary outcome measures The outcome measures of interest were the prevalence and determinants of undetected dementia. Results 23 studies were eligible for inclusion in this review. The pooled rate of undetected dementia was 61.7% (95% CI 55.0% to 68.0%). The rate of underdetection was higher in China and India (vs Europe and North America), in the community setting (vs residential/nursing care), age of <70 years, male gender and diagnosis by general practitioner. However, it was lower in the studies using Mini-Mental State Examination (MMSE) diagnosis criteria. Conclusions The prevalence of undetected dementia is high globally. Wide variations in detecting dementia need to be urgently examined, particularly in populations with low socioeconomic status. Efforts are required to reduce diagnostic inequality and to improve early diagnosis in the community.en
dc.language.isoenen
dc.publisherBMJ Openen
dc.relation.urlhttp://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2016-011146en
dc.rightsArchived with thanks to BMJ Openen
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/*
dc.subjectPrevalenceen
dc.subjectDeterminantsen
dc.subjectUnder-detectionen
dc.subjectDementiaen
dc.subjectMeta-analysisen
dc.titlePrevalence and determinants of undetected dementia in the community: a systematic literature review and a meta-analysisen
dc.typeArticleen
dc.identifier.journalBMJ Openen
dc.date.accepted2017-02-
rioxxterms.funderAlzheimer's Research UK, BUPA Foundation UKen
rioxxterms.identifier.projectUoW140617RCen
rioxxterms.versionVoRen
rioxxterms.licenseref.urihttps://creativecommons.org/CC BY-NC-ND 4.0en
rioxxterms.licenseref.startdate2017-06-14en
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