Almost one half of patients with dementia go undiagnosed in primary care

Almost half of patients with dementia referred to an outpatient geriatric clinic went undiagnosed at their initial primary care check-up, according to data presented at the American Geriatric Society Annual Scientific Meeting.

“In older adults, assessing cognitive impairment is part of routine primary care,” Cheryl A. Sadowski, PharmD, FCSHP, at the University of Alberta, Edmonton, Canada, and colleagues wrote. “However, challenges in assessing geriatric patients in primary care level have been described.”

To identify the prevalence of undiagnosed dementia, the researchers performed a retrospective review of 245 patients (mean age, 80.6 years; 63% female) who were referred to an outpatient geriatric clinic after being initially seen in primary care. Each patient was assessed using the comprehensive geriatric assessment. Most of the referrals (75%) were from family physicians and the most common reason for referral was memory decline (77%).

The researchers found that 26.2% of the cohort were diagnosed with dementia before referral, while 47.9% of the cohort were diagnosed after referral. There were significant differences in the cognitive measurements administered before referral vs. after assessment. Fewer patients had their vitamin B12 examined before referral: 4.1% vs. 20.5% of patients after referral (P < .0001). This was also true for calcium (20.9% vs. 37.7%, P = .0002), the Mini Mental State Examination test (9.8% vs. 92.6%, P < .0001) and the Montreal Cognitive assessment (0.4% vs. 25.0%, P < .0001).

“Cognition remains a diagnostic challenge despite current dementia guidelines providing clear instructions,” Sadowski and colleagues wrote. – by Will Offit

Reference:

Ong S, et al. Abstract B98. Presented at: the 2016 American Geriatric Society Annual Scientific Meeting; May 19-20; Long Beach, California.

Disclosures: Sadowski reports receiving funding from Pfizer.