Determinants for undetected dementia and late-life depression

Br J Psychiatry. 2013 Sep;203(3):203-8. doi: 10.1192/bjp.bp.112.119354. Epub 2013 Jul 25.

Abstract

Background: Determinants for undetected dementia and late-life depression have been not well studied.

Aims: To investigate risk factors for undetected dementia and depression in older communities.

Method: Using the method of the 10/66 algorithm, we interviewed a random sample of 7072 participants aged ≥60 years in six provinces of China during 2007-2011. We documented doctor-diagnosed dementia and depression in the interview. Using the validated 10/66 algorithm we diagnosed dementia (n = 359) and depression (n = 328).

Results: We found that 93.1% of dementia and 92.5% of depression was undetected. Both undetected dementia and depression were significantly associated with low levels of education and occupation, and living in a rural area. The risk of undetected dementia was also associated with 'help available when needed', and inversely, with a family history of mental illness and having functional impairment. Undetected depression was significantly related to female gender, low income, having more children and inversely with having heart disease.

Conclusions: Older adults in China have high levels of undetected dementia and depression. General socioeconomic improvement, associated with mental health education, targeting high-risk populations are likely to increase detection of dementia and depression in older adults, providing a backdrop for culturally acceptable service development.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Algorithms
  • China / epidemiology
  • Delayed Diagnosis
  • Dementia / diagnosis*
  • Dementia / epidemiology
  • Depressive Disorder / diagnosis*
  • Depressive Disorder / epidemiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Rural Health
  • Urban Health