Study Finds Delay in Initial Dementia Diagnosis

A new study has found that dementia patients are not undergoing evaluation at the onset of the dementia process, a delay that prevents early, beneficial treatment.

The study, conducted by a multidisciplinary Spectrum Health neurology team, also found that home-based, patient-centered care may improve early screening and detection of dementia.

For the new study, researchers reviewed 110 randomly-chosen initial evaluations from the Spectrum Health Medical Group Neurocognitive Clinic in Grand Rapids, Michigan, from 2008 to 2015.

They discovered that 78.9 percent of the patients evaluated already had moderate or severe dementia at the time of diagnosis.

“The findings indicate that people are living with dementia for significant periods of time before seeking diagnosis and treatment,” said Timothy Thoits, M.D., lead author and neurology division chief, Spectrum Health Medical Group. “The earlier the diagnosis, the earlier treatment can begin and the earlier the benefit to the patient and his or her family and caregivers.”

The researchers reviewed the initial diagnostic patient evaluations, which included a neurological examination, Montreal Cognitive Assessment, and a battery of neuropsychological testing. They determined dementia stage and severity by correlating it with the number of lifestyle changes recommended at the time of diagnosis, which they say is a novel study method that has not previously been used.

Lifestyle changes included medication assistance, financial assistance, driving restrictions, and institutional care. At the time of diagnosis, providers recommended lifestyle changes in 75.8 percent of patients with dementia.

The study concludes that “an increase in home-based, patient-centered medical care, regardless of the patient’s living status, may be one way to improve recognition of cognitive deficits and increase the frequency of important and necessary early cognitive evaluations.”

The World Health Organization (WHO) defines home-based care as “any form of assistance provided to a sick person referred to as the patient directly in the home by family, friends, and members of the local community, cooperating with the advice and support from the trained health workers.”

The study was published in The American Journal of Alzheimer’s Disease & Other Dementias.

Source: Spectrum Health

Photo: Timothy Thoits, M.D., lead author and neurology division chief, Spectrum Health Medical Group. Credit: Spectrum Health.