Geographical Variation in the Diagnostic Rate and Quality of Dementia Diagnoses

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  • Johanne Købstrup Zakarias, Københavns Universitet, Danmark
  • Christina Jensen-Dahm, Københavns Universitet, Danmark
  • Ane Nørgaard, Københavns Universitet, Danmark
  • Peter Roos, Københavns Universitet, Danmark
  • Christiane Gasse
  • Thien Kieu Thi Phung, Københavns Universitet, Danmark
  • Gunhild Waldemar, Københavns Universitet, Danmark

Background: Early and accurate diagnosis of dementia opens the door to appropriate treatment, support, and counseling. Despite availability of evidence-based guidelines for diagnostic evaluation of dementia, the diagnostic rate in people with dementia is low and the quality of dementia diagnoses is unknown. Objective: The overall aim of this register-based study was to analyze the quality of diagnostic evaluation of dementia by assessing nationwide geographical variations in a range of indicators. Methods: A register-based cross-sectional study of the entire Danish population aged 65 years or older in 2015 was conducted. The surrogate indicators for diagnostic quality included 1) prevalence rates of dementia diagnoses, 2) incidence rates of dementia diagnoses, 3) age at first diagnosis of dementia, 4) medical specialty responsible for diagnosis, 5) diagnostic rate of dementia subtypes, and 6) use of anti-dementia medication. The indicators were compared across the five Danish regions. Results: The national prevalence and incidence of registered dementia diagnoses was 3.0% and 0.5%, respectively. The proportion of patients diagnosed at a dementia specialist department ranged from 60.9% to 90.5% across the five regions, subtype specific diagnosis ranged from 45.3% to 75.5%, and use of anti-dementia medication ranged from 29.2% to 58.3%. Conclusion: The observed geographical variations in dementia diagnoses and treatment indicate inequality in the access to appropriate diagnostic evaluation and care for patients with dementia. Our findings call for more awareness of the benefits of timely diagnosis and for improvement in the quality of diagnostic evaluation of dementia.

TidsskriftJournal of Alzheimer's Disease
Sider (fra-til)513-520
Antal sider8
StatusUdgivet - maj 2019

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