Cited by 969Dementia and Cognitive Impairment ResearchClinical Reasoning and Diagnostic SkillsPrimary Care and Health Outcomes

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Missed and Delayed Diagnosis of Dementia in Primary Care: Prevalence and Contributing Factors

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Bradford, Andrea, Kunik, Mark E., Schulz, Paul, Williams, Susan P., Singh, Hardeep·2009·Alzheimer Disease & Associated Disorders

DOI 10.1097/wad.0b013e3181a6bebcPMC PMC2787842

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Abstract

Dementia is a growing public health problem for which early detection may be beneficial. Currently, the diagnosis of dementia in primary care is dependent mostly on clinical suspicion on the basis of patient symptoms or caregivers' concerns and is prone to be missed or delayed. We conducted a systematic review of the literature to ascertain the prevalence and contributing factors for missed and delayed dementia diagnoses in primary care. Prevalence of missed and delayed diagnosis was estimated by abstracting quantitative data from studies of diagnostic sensitivity among primary care providers. Possible predictors and contributory factors were determined from the text of quantitative and qualitative studies of patient, caregiver, provider, and system-related barriers. Overall estimates of diagnostic sensitivity varied among studies and seemed to be in part a function of dementia severity, degree of patient impairment, dementia subtype, and frequency of patient-provider contact. Major contributory factors included problems with attitudes and patient-provider communication, educational deficits, and system resource constraints. The true prevalence of missed and delayed diagnoses of dementia is unknown but seems to be high. Until the case for dementia screening becomes more compelling, efforts to promote timely detection should focus on removing barriers to diagnosis.

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Authors: Bradford, A., Kunik, M. E., Schulz, P., Williams, S. P., & Singh, H.
Affiliations: Baylor College of Medicine (US)
Michael E. DeBakey VA Medical Center (US)
Corresponding author: Bradford, Andrea
ORCID: Bradford, Andrea
Kunik, Mark E.
Schulz, Paul
Singh, Hardeep
Venue: Alzheimer Disease & Associated Disorders
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2009-10
Volume: 23
Issue: 4
Pages: 306-314
ISSN: 0893-0341 (ISSN-L)
DOI: 10.1097/wad.0b013e3181a6bebc
PMC: PMC2787842
OpenAlex: W2055531721
Cited by: 969
References: 76
Citations by year: 2026: 69 · 2025: 101 · 2024: 108 · 2023: 83 · 2022: 116 · 2021: 74 · 2020: 73 · 2019: 65 · 2018: 64 · 2017: 41 · 2016: 39 · 2015: 36 · 2014: 20 · 2013: 25 · 2012: 30
FWCI: 2.31
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: Alzheimer Disease & Associated Disorders (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: National Cancer Institute (K23CA125585)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
Health Sciences › Medicine › Family Practice › Primary Care and Health Outcomes
Keywords: dementia, missed diagnosis, delayed diagnosis, primary care, diagnostic sensitivity, dementia screening, barriers to diagnosis, patient-provider communication, caregiver concerns, dementia severity, dementia subtypes, educational deficit
MeSH terms: Dementia, Diagnostic Errors, Humans, Primary Health Care, Risk Factors, Prevalence, Delayed Diagnosis

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Missed and Delayed Diagnosis of Dementia in Primary Care: Prevalence and Contributing Factors

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