What Could Be the Main Levers to Promote a Timely Diagnosis of Neurocognitive Disorders?

Abstract

Background: Neurocognitive disorders (NCD) are a growing health issue and the importance of diagnosis is still debated despite the benefits of making a diagnosis appearing to be greater than the risks.

Objective: The aim of the present study was to explore the perception of the main benefits and risks to perform a diagnosis workup of NCD in a population of general practitioners (GPs), specialized physicians (SPs), other healthcare professionals (OHPs), and informal caregivers (ICs), and to identify the lowest perceived benefits and the highest perceived risks that could be levers to promote a diagnosis of NCD.

Methods: A standardized questionnaire was submitted to GPs, SPs, OHPs, and ICs aiming to evaluate the importance of eight benefits and eight risks related to NCD diagnosis (selected from the literature) for four prototypical clinical cases at different stages of the disease: subjective cognitive impairment/mild NCD, major NCD at mild/moderate stage, moderate stage with behavioral and psychotic symptoms, and severe stage.

Results: The lowest perceived benefits of making an NCD diagnosis were "access to medical research", "patient's right to know", and "initiation of symptomatic drug treatment". The highest perceived risks of making an NCD diagnosis were "negative psychological impact for the patient", "absence of disease-modifying treatment", and "absence of suitable institution".

Conclusion: This study highlights the lowest perceived benefits and the highest perceived risks of making an NCD diagnosis. These benefits and risks could be modified to become levers to promote a personalized diagnosis of NCD.

Keywords: Benefits and risks; ethical issues; neurocognitive disorders; personalized diagnosis; timely diagnosis.