P2–100: Factors influencing the frequency of dementia evaluations in a population–representative sample in the United States
Year: 2006
Type: article
Abstract: Early interventions are most effective for treating dementia, but there is often a delay of several years after symptom onset before medical advice is sought. Many never receive a dementia evaluation or learn the cause of their symptoms, substantially impeding care. To ascertain how demographic and economic factors influence the frequency of community diagnostic evaluations in individuals found to have dementia in a research study. We performed in–home neurological and neuropsychological evaluations in the Aging, Demographics, and Memory Study (ADAMS), a stratified subsample of 856 participants in the Health and Retirement Study (HRS), a representative population sample in the United States. A consensus panel reviewed the research evaluations and determined whether dementia was present. Knowledgeable informants for each subject were asked whether a prior evaluation for memory problems had been performed. We also obtained and reviewed available medical records for these subjects. A total of 308 individuals in ADAMS had a research diagnosis of dementia (mean age 85; mean education 9.5 years; 31% men, 69% women; 73% white, 23% African–American). A community physician had evaluated 47% of the demented subjects. The cause of memory problems in the 145 demented individuals was reported only as dementia in 28% and informants were uncertain whether the physician had identified a cause in 14%. When a specific diagnosis was reported, it was Alzheimer's disease in 27%, stroke or TIA in 14%, other conditions in 16%, and normal aging in 2%. The likelihood of a prior dementia evaluation increased with dementia severity (p=0.0001), younger age (p=0.01), more education (p=0.03), higher household net worth, and female gender (odds ratio 2.24, p=0.001). Geographic region, marital status and race did not significantly affect the likelihood of evaluation. Even in the minority of demented patients who were previously evaluated, family members often don't know the specific cause. Demographic and economic factors are important determinants of whether a dementia evaluation is performed, and substantial efforts will be needed to achieve early and specific treatment of dementing disorders.
Source: Alzheimer s & Dementia
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2749678134