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

Lang, Linda; Clifford, Angela; Wei, Li; Zhang, Dongmei; Leung, Daryl; Augustine, Glenda; Danat, Isaac M; Zhou, Weiju; Copeland, John R; Chen, Ruoling; Anstey, Kaarin

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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....[Show more]

dc.contributor.authorLang, Linda
dc.contributor.authorClifford, Angela
dc.contributor.authorWei, Li
dc.contributor.authorZhang, Dongmei
dc.contributor.authorLeung, Daryl
dc.contributor.authorAugustine, Glenda
dc.contributor.authorDanat, Isaac M
dc.contributor.authorZhou, Weiju
dc.contributor.authorCopeland, John R
dc.contributor.authorChen, Ruoling
dc.contributor.authorAnstey, Kaarin
dc.date.accessioned2017-03-08T03:33:06Z
dc.date.available2017-03-08T03:33:06Z
dc.identifier.urihttp://hdl.handle.net/1885/112977
dc.description.abstractOBJECTIVES 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.
dc.description.sponsorshipRC and LW thank Alzheimer’s Research and BUPA Foundation UK to provide research grants for the Research Programme of Dementia in China, particularly focusing on the early detection of dementia in older people. KJA is funded by NHMRC Fellowship #1002560 and acknowledges support from the Dementia Collaborative Research Centres.
dc.format8 pages
dc.format.mimetypeapplication/pdf
dc.publisherBMJ Publishing Group
dc.rightsThis is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work noncommercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http:// creativecommons.org/licenses/by-nc/4.0/
dc.sourceBMJ open
dc.subjectgeriatric medicine
dc.titlePrevalence and determinants of undetected dementia in the community: a systematic literature review and a meta-analysis
dc.typeJournal article
local.identifier.citationvolume7
dcterms.dateAccepted2017-01-11
dc.date.issued2017
local.publisher.urlhttp://authors.bmj.com/
local.type.statusPublished Version
local.contributor.affiliationAnstey, Kaarin J., Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, The Australian National University
dc.relationhttp://purl.org/au-research/grants/nhmr/1002560
local.identifier.essn2044-6055
local.bibliographicCitation.issue2
local.bibliographicCitation.startpagee011146
local.identifier.doi10.1136/bmjopen-2016-011146
dcterms.accessRightsOpen Access
CollectionsANU Research Publications

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