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Barriers to dementia diagnosis in India: Effect of education, dementia subtype and age at onset
Author(s) -
Ellajosyula Ratnavalli,
Narayanan Jwala
Publication year - 2020
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.045111
Subject(s) - dementia , medicine , pediatrics , vascular dementia , neuropsychology , frontotemporal dementia , disease , dementia with lewy bodies , psychiatry , cognition
Abstract Background Early diagnosis in dementia is crucial for management but there is usually a time lag between symptom onset and dementia diagnosis. The prevalence and factors associated with delay in seeking help for people with dementia in India is unknown. Method Consecutive patients with dementia (n=924) seen at a memory clinic were enrolled in the study after informed consent. All patients underwent a standard clinical assessment, neuropsychological tests and neuroimaging. The main outcome variable was time from symptom onset to diagnosis (TTD). The effect of age, education, early onset (EOD‐<65 years) and late onset (LOD‐>65 years), dementia subtype, and gender on TTD were examined using a general linear model. Result The mean age of the whole group was 70.15(9.1) years and the mean TTD was 32.2 (26.6) months. There was a significant effect of age at onset (EOD 37.2 months vs LOD 27 months), education [(0‐4 years‐37.9 months) vs (5‐12 years ‐27.42 months)] and dementia subtype. Patients with vascular dementia (25.4months) and dementia with Lewy bodies (23.5 months) presented earlier as compared to patients with Alzheimer’s disease (33.4 months) and Frontotemporal dementia (36.8 months). Conclusion People with dementia in India are diagnosed much later, approximately 3 years after symptom onset as compared to other Western and Asian studies (1‐2 years). Clinical features and low education may be barriers to seek help for dementia diagnosis.