Prevalence and determinants of undetected dementia in the community: a systematic literature review and a meta-analysis
Authors
Lang, LindaClifford, Angela
Wei, Li
Zhang, Dongmei
Leung, Daryl
Augustine, Glenda
Danat, Isaac M
Zhou, Weiju
Copeland, John R
Anstey, Kaarin J.
Chen, Ruoling
Issue Date
2017-02-03
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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
Lang, L. et. al. (2017) Prevalence and determinants of undetected dementia in the community: a systematic literature review and a meta-analysis, BMJ Open, 7(2), doi: 10.1136/bmjopen-2016-011146Publisher
BMJ OpenJournal
BMJ OpenAdditional Links
http://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2016-011146Type
Journal articleLanguage
enISSN
2044-6055ae974a485f413a2113503eed53cd6c53
10.1136/bmjopen-2016-011146
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