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Delay in the diagnosis of dementia in urban India: Role of dementia
subtype and age at onset
Authors:
Ellajosyula, R., Narayanan, J., Hegde, S.,
Kamath, V., Murgod, U., Easwaran, V., Seetharam, R., Srinivasan, M., WATSON, P.
Reference:
International Journal of Geriatric Psychiatry, 37(12)
Year of publication:
2022
CBU number:
8859
Abstract:
Background
Early diagnosis of dementia is crucial for timely intervention. However,
frequently, there is a substantial delay in diagnosis. Therefore, it is essential
to recognise and address the barriers to early diagnosis. These have not
been systematically studied in India. We at a specialist memory clinic in India
investigated the time from symptom onset to diagnosis of dementia and
factors contributing to the delay.
Methods
In this cross-sectional study, consecutive patients with dementia (n=855) seen
at a private hospital underwent a standard clinical assessment and
investigations. The primary outcome variable was time from symptom onset
to diagnosis (TTD). The association of age, education, gender, dementia
subtype, and age of onset on TTD were examined using a univariate analysis
of covariance.
Results
The median TTD was 24 months; 43% were diagnosed after 24 months.
There was a significant association between TTD and age at onset (young
onset – median 36 months vs late onset – 24 months) and dementia subtype.
Patients with vascular dementia were diagnosed significantly earlier as
compared to patients with Alzheimer’s disease (AD) and Frontotemporal
dementia (FTD) [median 18, 24, and 30 months, respectively]. There was no
effect of gender or education on the TTD.
Conclusion
About 40% of patients with dementia were diagnosed more than two years
after symptom onset, particularly young onset dementias and FTD. Our
study findings highlight the gaps in diagnosing patients with dementia in urban
India and have significant implications for developing and implementing
multifaceted interventions to improve the early diagnosis of dementia.
Data available, click to request