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Undiagnosed Dementia Surprisingly Common in Older Americans, Study Suggests
Nine out of 10 older Americans with cognitive impairment consistent with dementia reported never having received a formal dementia diagnosis, according to study findings published online ahead of print in the Journal of Alzheimer’s Disease.
“[The discrepancy] was higher than I was expecting,” said study coauthor Sheria Robinson-Lane, PhD, RN, assistant professor at the University of Michigan School of Nursing in Ann Arbor.
The study included more than 6 million US adults, age 65 and older, identified as having cognitive impairment consistent with dementia. Participants took part in at least one wave of the Health and Retirement Study. Cognitive functioning was assessed through the adapted Telephone Interview of Cognitive Status. Dementia diagnosis was self-reported by participants or proxy reporters, who were mostly family members.
The study found that 91.4% of participants with cognitive impairment consistent with dementia reported having received no dementia-related diagnosis. When proxy reporters responded, the prevalence of no dementia-related diagnosis despite cognitive impairment consistent with dementia dropped to 75%.
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When researchers looked at factors such as race, sex, and education, they found the rates of no dementia diagnosis despite cognitive impairment consistent with dementia of 93.3% among participants who identified non-Hispanic black, 99.7% among males, and 93.5% among people who did not graduate from high school.
“There is a large disparity in dementia-related treatment and diagnosis among Black older adults, who are often diagnosed much later in the disease trajectory compared to other racial and ethnic groups,” said Dr Robinson-Lane.
She encouraged dementia screening during routine health assessments for older adults, pointing out that COVID-19 has been linked with increased risk for hospitalization and death in people with dementia. Additionally, the neurological effects of COVID-19 can be long-lasting in some people, possibly increasing their risk for dementia.
“Now more than ever, these routine screenings and assessments are really critical,” she said. “I think it’s particularly important to have some baseline information available to providers of patients over 65.”
—Jolynn Tumolo
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