Attitude toward dementia and preferences for diagnosis in Japanese health service consumers

Abstract

Background Being diagnosed with dementia is a confronting experience for any individual and their caregiver. However, a diagnosis provides opportunity for future preparation for management of the condition. This study investigated attitudes toward dementia and preferences for diagnosis among a sample of health service consumers in Japan. Methods Participants were patients or accompanying support persons (n = 217) who visited the specialty outpatient clinic of four hospital departments. The survey was conducted using an iPad with answers sent automatically to a secure server. The survey included items about the participants’ most feared diseases and the reasons behind those fears, estimates of dementia prevalence in Japan, and preferences regarding a diagnosis of dementia and the reasons for their preference. Results The most feared disease was cancer (43.8 %), followed by dementia (18 %). Those selecting dementia most commonly reported practical, emotional and social impacts as the reasons why they most feared this condition. Almost all participants preferred to know the diagnosis of dementia as soon as possible for themselves, with significantly fewer preferring their spouse to know as soon as possible if they had dementia (95.9 % for self vs. 67.5 % for partner/spouse, p < 0.001). On average, participants estimated that 18.1 % of Japanese people are diagnosed with dementia by age 65, while they thought that 43.7 % of Japanese people are diagnosed with dementia by age 85. Conclusions The findings highlight a need for community education about the significant impacts of dementia on the lives of individuals and their caregivers. People were more reluctant for their spouse to receive a diagnosis as soon as possible if they had dementia. Physicians should sensitively disclose diagnosis and ensure they involve both the patient and their relatives in discussions about diagnosis disclosure.

Inter‐rater reliability of the Conversational Assessment of Neurocognitive Dysfunction

“…This is because older people living in the care community are reluctant to receive a diagnosis that may indicate that they have dementia. 29 Moreover, in long-term care settings, embedded communication is reported to be a requirement to meet the social and emotional needs of residents, as the care staff often lack time to interact with them. [30][31][32] The CANDy enables the users of the assessment to provide both the communication that the residents require and the ability to evaluate their cognitive function.…”

“…For instance, cognitive tests are often regarded as psychologically invasive, 7 thereby making it difficult to evaluate cognitive functions in older adults living in the community. This is because older people living in the care community are reluctant to receive a diagnosis that may indicate that they have dementia 29 . Moreover, in long‐term care settings, embedded communication is reported to be a requirement to meet the social and emotional needs of residents, as the care staff often lack time to interact with them 30–32 .…”

Survey on the current situation for early diagnosis of dementia and contributing factors in Japan

“…At the same time, most of the general public would like to be diagnosed as early as possible in relation to themselves, while there is a declining trend in relation to their spouses, but overall, the demand for early diagnosis of dementia is increasing. 5,6 Currently, the diagnosis and subsequent use of services in relation to dementia tend to be generally delayed. 7 A 2019 European survey of caregivers' views reported that only half of caregivers said they had made timely progress in diagnosing dementia.…”

Attitudes toward dementia screening and influential factors in older adults in China

“…Some studies reported different perspectives and found that more than half of all older adults were unwilling to accept routine dementia screenings because of their belief that dementia screening would reduce their confidence in independent living and create stigma 10 . Previous research suggests that age, education level, dementia‐related knowledge, and marital status were factors affecting older adults' attitudes toward dementia screening 11–13 . People refuse to undergo dementia screening for several reasons, such as stigma, societal stress, and economic burden 14 .…”

“…10 Previous research suggests that age, education level, dementia-related knowledge, and marital status were factors affecting older adults' attitudes toward dementia screening. [11][12][13] People refuse to undergo dementia screening for several reasons, such as stigma, societal stress, and economic burden. 14 However, the aims have varied in existing studies, and no definitive conclusion has been drawn.…”