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Meta-Analysis
. 2017 Feb 3;7(2):e011146.
doi: 10.1136/bmjopen-2016-011146.

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

Linda Lang  1   2 , Angela Clifford  1 , Li Wei  3 , Dongmei Zhang  4 , Daryl Leung  5 , Glenda Augustine  6 , Isaac M Danat  1 , Weiju Zhou  1 , John R Copeland  7 , Kaarin J Anstey  8 , Ruoling Chen  1   2
Affiliations
Meta-Analysis

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

Linda Lang et al. BMJ Open. .

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.

Keywords: GERIATRIC MEDICINE.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Forest plot for these 23 studies.
See this image and copyright information in PMC

References

    1. Sternberg SA, Wolfson C, Baumgarten M. Undetected dementia in community-dwelling older people: the Canadian Study of Health and Aging. J Am Geriatr Soc 2000;48:1430–4. 10.1111/j.1532-5415.2000.tb02633.x - DOI - PubMed
    1. Prince M, Bryce R, Ferri C. World Alzheimer Report 2011: the benefits of early diagnosis and intervention Alzheimer's Disease International, 2011.
    1. Bishop NA, Lu T, Yankner BA. Neural mechanisms of ageing and cognitive decline. Nature 2010;464:529–35. 10.1038/nature08983 - DOI - PMC - PubMed
    1. Iliffe S, Robinson L, Brayne C et al. . Primary care and dementia: 1. diagnosis, screening and disclosure. Int J Geriatr Psychiatry 2009;24:895–901. 10.1002/gps.2204 - DOI - PubMed
    1. Connolly A, Gaehl E, Martin H et al. . Underdiagnosis of dementia in primary care: variations in the observed prevalence and comparisons to the expected prevalence. Aging Ment Health 2011;15:978–84. 10.1080/13607863.2011.596805 - DOI - PubMed

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