Underdiagnosis of dementia in primary care: Variations in the observed prevalence and comparisons to the expected prevalence

Connolly, A.; Gaehl, Ella; Martin, Helen; Morris, Julie; Purandare, Nitin

doi:10.1080/13607863.2011.596805

Cited by 251 publications

(208 citation statements)

References 26 publications

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“…GPs from larger practices were more likely to correctly rule-out dementia. Interestingly, Connolly et al (2011) reported lower rates of diagnosis in practices with one GP as opposed to several. They considered that one of the reasons for this may have been lack of time for the solo GP.…”

Section: Discussionmentioning

confidence: 95%

Predictors of agreement between general practitioner detection of dementia and the revised Cambridge Cognitive Assessment (CAMCOG-R)

Pond

Mate

Phillips

et al. 2013

Int. Psychogeriatr.

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Section: Discussionmentioning

confidence: 95%

Predictors of agreement between general practitioner detection of dementia and the revised Cambridge Cognitive Assessment (CAMCOG-R)

Pond

Mate

Phillips

et al. 2013

Int. Psychogeriatr.

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“…Alzheimer's disease does not have a diagnostic test for confirmation purposes (St Germaine-Smith et al, 2012) and underdiagnosis of dementia is a significant problem (Boustani et al, 2003;ADI, 2011;Connolly et al, 2011). Therefore, the case definition for the present study prioritized sensitivity over specificity by including prescription drug and long-term care data to account for dementia cases that may not have been identified in physician or hospital data.…”

Section: Cohortmentioning

confidence: 99%

Simultaneous temporal trends in dementia incidence and prevalence, 2005–2013: a population-based retrospective cohort study in Saskatchewan, Canada

Kosteniuk

Morgan

O’Connell

et al. 2016

Int. Psychogeriatr.

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Background:Original studies published over the last decade regarding time trends in dementia report mixed results. The aims of the present study were to use linked administrative health data for the province of Saskatchewan for the period 2005/2006 to 2012/2013 to: (1) examine simultaneous temporal trends in annual age-and sex-specific dementia incidence and prevalence among individuals aged 45 and older, and (2) stratify the changes in incidence over time by database of identification.

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“…All patients on dementia registers were included; however, dementia may remain undiagnosed in up to 50% of patients, which could have led to underestimation of true effect. 41 Measures of care that rely on the evaluation of medical records, such as history taking, have been associated with poorer overall quality of care 42 and medical records may not give an accurate reflection of the actual care provided. However, documented care is, in itself, a measure of quality.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

“…• the detection rates of dementia, and associated behavioural and psychological symptoms of dementia; [22][23][24] • end-of-life care; 25 and…”

Section: Introductionmentioning

confidence: 99%

Under-provision of medical care for vascular diseases for people with dementia in primary care: a cross-sectional review

Connolly

Campbell²,

Gaehl³

et al. 2013

Br J Gen Pract

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BackgroundVascular diseases contribute to the causation and progression of clinical dementia. AimTo evaluate the quality of medical care for vascular diseases provided to people with dementia, the patient and practice characteristics that influence quality, and to compare care with that provided to those without dementia. Design and settingObservational, cross-sectional review of primary care records of people with dementia from 52 general practices from five primary care trusts in the UK, and comparison with publicly available summary data on patients without dementia. MethodA total of 700 patients with ≥1 diagnosed vascular disease or risk factor were identified from dementia registers. Quality of care was measured on 30 indicators from the UK Quality and Outcomes Framework (QOF) for hypertension, coronary heart disease, stroke, diabetes mellitus, atrial fibrillation, heart failure, and smoking. Overall quality of vascular care was calculated for each patient with dementia. ResultsLevel of care received by people with dementia was significantly lower compared with those without dementia for 22 of 30 (73%) indicators; most notably for measurement processes such as peripheral pulses check and neuropathy testing for diabetes, and cholesterol measures for stroke. Among people with dementia, women, those in care homes, and those with fewer comorbid physical conditions and medications were associated with lower scores for overall quality of vascular care. ConclusionThe quality of medical care provided to people with dementia with regard to vascular diseases is not concordant with quality, as defined by the QOF. Research is needed to improve access to high-quality care.

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Underdiagnosis of dementia in primary care: Variations in the observed prevalence and comparisons to the expected prevalence

Cited by 251 publications

References 26 publications

Predictors of agreement between general practitioner detection of dementia and the revised Cambridge Cognitive Assessment (CAMCOG-R)

Predictors of agreement between general practitioner detection of dementia and the revised Cambridge Cognitive Assessment (CAMCOG-R)

Simultaneous temporal trends in dementia incidence and prevalence, 2005–2013: a population-based retrospective cohort study in Saskatchewan, Canada

Under-provision of medical care for vascular diseases for people with dementia in primary care: a cross-sectional review

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