Facilitators and Barriers to Dementia Assessment and Diagnosis: Perspectives From Dementia Experts Within a Global Health Context

Alissa Bernstein Sideman^{1

2

3}, Tala Al-Rousan^{2

4}, Elena Tsoy^{2

5}, Stefanie D Piña Escudero^{2

5}, Maritza Pintado-Caipa^{2

6}, Suchanan Kanjanapong^{2

7}, Lingani Mbakile-Mahlanza^{2

8}, Maira Okada de Oliveira^{2

9

10}, Myriam De la Cruz-Puebla^{11

12

13

14

15}, Stelios Zygouris^{2

16}, Aya Ashour Mohamed^{2

17}, Hany Ibrahim^{11

18}, Collette A Goode⁵, Bruce L Miller^{2

5}, Victor Valcour^{2

5}, Katherine L Possin^{2

5}

Affiliations

¹ Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA, United States.
² Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States.
³ Department of Humanities and Social Sciences, University of California, San Francisco, San Francisco, CA, United States.
⁴ Herbert Wertheim School of Public Health, University of California, La Jolla, CA, United States.
⁵ Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States.
⁶ Research Department, Peruvian Institute of Neurosciences, Lima, Peru.
⁷ Division of Geriatrics, Department of Preventive Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
⁸ Department of Psychology, Faculty of Social Sciences, University of Botswana, Gaborone, Botswana.
⁹ Cognitive and Behavioral Neurology Unit, Hospital das Clinicas, University of São Paulo, São Paulo, Brazil.
¹⁰ Hospital Santa Marcelina, São Paulo, São Paulo, Brazil.
¹¹ Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland.
¹² Neurosciences Institute, Autonomous University of Barcelona, Barcelona, Spain.
¹³ Cognition and Brain Plasticity Unit, University of Barcelona, Barcelona, Spain.
¹⁴ Bellvitge Institute for Biomedical Research, Barcelona, Spain.
¹⁵ Technical University of Ambato, Tungurahua, Ecuador.
¹⁶ Centre for Research and Technology Hellas/Information Technologies Institute, Thessaloniki, Greece.
¹⁷ Department of Neurology, Ain Shams University, Cairo, Egypt.
¹⁸ Geriatric Medicine Department, Ain Shams University, Cairo, Egypt.

PMID: 35418934
PMCID: PMC8997042
DOI: 10.3389/fneur.2022.769360

Facilitators and Barriers to Dementia Assessment and Diagnosis: Perspectives From Dementia Experts Within a Global Health Context

Alissa Bernstein Sideman et al. Front Neurol. 2022.

. 2022 Mar 28:13:769360.

doi: 10.3389/fneur.2022.769360. eCollection 2022.

Authors

Affiliations

¹ Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA, United States.
² Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States.
³ Department of Humanities and Social Sciences, University of California, San Francisco, San Francisco, CA, United States.
⁴ Herbert Wertheim School of Public Health, University of California, La Jolla, CA, United States.
⁵ Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States.
⁶ Research Department, Peruvian Institute of Neurosciences, Lima, Peru.
⁷ Division of Geriatrics, Department of Preventive Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
⁸ Department of Psychology, Faculty of Social Sciences, University of Botswana, Gaborone, Botswana.
⁹ Cognitive and Behavioral Neurology Unit, Hospital das Clinicas, University of São Paulo, São Paulo, Brazil.
¹⁰ Hospital Santa Marcelina, São Paulo, São Paulo, Brazil.
¹¹ Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland.
¹² Neurosciences Institute, Autonomous University of Barcelona, Barcelona, Spain.
¹³ Cognition and Brain Plasticity Unit, University of Barcelona, Barcelona, Spain.
¹⁴ Bellvitge Institute for Biomedical Research, Barcelona, Spain.
¹⁵ Technical University of Ambato, Tungurahua, Ecuador.
¹⁶ Centre for Research and Technology Hellas/Information Technologies Institute, Thessaloniki, Greece.
¹⁷ Department of Neurology, Ain Shams University, Cairo, Egypt.
¹⁸ Geriatric Medicine Department, Ain Shams University, Cairo, Egypt.

PMID: 35418934
PMCID: PMC8997042
DOI: 10.3389/fneur.2022.769360

Abstract

Objectives: Dementia poses one of the greatest global health challenges, affecting 50 million people worldwide. With 10 million new cases each year, dementia is a growing burden, particularly in low- and middle-income countries (LMIC). This study aimed to identify the facilitators and barriers to providing quality dementia assessment and care in LMICs from a global health perspective.

Methods/design: A qualitative semi-structured interview study with 20 dementia expert healthcare providers from 19 countries. To be included, providers had to: practice dementia assessment or care in LMICs where the population over age 60 is projected to more than double by 2050 and be recognized as a leading dementia expert in the region based on position, research publications, and/or policy leadership. Interviews were analyzed by a multidisciplinary team of researchers using thematic analysis.

Results: Barriers to dementia assessment and care included stigma about dementia, poor patient engagement in and access to healthcare, inadequate linguistic and cultural validation, limited dementia capable workforce, competing healthcare system priorities, and insufficient health financing. Facilitators included the rise in dementia awareness campaigns, dementia training for general practitioners, availability of family support and family caregivers, and national and international collaborations including coordinated policy efforts and involvement in international research initiatives.

Conclusions: Findings from this study provide insights for prioritizing dementia assessment and care capacity-building in LMICs as a global health priority and for tailored public health approaches to strengthen dementia assessment and care at the individual, community, national, and multi-national levels.

Keywords: cognitive assessment; dementia; dementia experts; global health; qualitative study.

Copyright © 2022 Bernstein Sideman, Al-Rousan, Tsoy, Piña Escudero, Pintado-Caipa, Kanjanapong, Mbakile-Mahlanza, Okada de Oliveira, De la Cruz-Puebla, Zygouris, Ashour Mohamed, Ibrahim, Goode, Miller, Valcour and Possin.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

**Figure 1**
Social ecological model of health.

See this image and copyright information in PMC

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Facilitators and Barriers to Dementia Assessment and Diagnosis: Perspectives From Dementia Experts Within a Global Health Context

Affiliations

Facilitators and Barriers to Dementia Assessment and Diagnosis: Perspectives From Dementia Experts Within a Global Health Context

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Grants and funding

LinkOut - more resources

Full Text Sources