The estimated prevalence of no reported dementia-related diagnosis in older Americans living with possible dementia by healthcare utilization

Aging Clin Exp Res. 2022 Feb;34(2):359-365. doi: 10.1007/s40520-021-01980-2. Epub 2021 Sep 15.


Background: Screening for dementia in relevant healthcare settings may help in identifying low cognitive functioning for comprehensive cognitive assessments and subsequent dementia treatment after diagnosis.

Aims: This study sought to estimate the prevalence of no reported dementia-related diagnosis in a nationally-representative sample of older Americans with a cognitive impairment consistent with dementia (CICD) by healthcare utilization.

Methods: The unweighted analytical sample included 1514 Americans aged ≥ 65 years that were identified as having a CICD without history of stroke, cancers, neurological conditions, or brain damage who participated in at least one-wave of the 2010-2016 waves of the Health and Retirement Study. An adapted Telephone Interview of Cognitive Status assessed cognitive functioning. Those with scores ≤ 6 had a CICD. Dementia-related diagnosis was self-reported. Respondents indicated if they visited a physician, received home healthcare, or experienced an overnight nursing home stay in the previous two years.

Results: The prevalence of no reported dementia-related diagnosis in persons with a CICD who visited a physician was 89.9% (95% confidence interval (CI): 85.4%-93.1%). Likewise, the prevalence of no reported diagnosis in those with a CICD who received home healthcare was 84.3% (CI: 75.1-90.5%). For persons with a CICD that had an overnight nursing home stay, the prevalence of no reported dementia-related diagnosis was 83.0% (CI: 69.1-91.4%).

Discussion: Although the prevalence of no reported dementia-related diagnosis in individuals with a CICD differed across healthcare settings, the prevalence was generally high nonetheless.

Conclusions: We recommend increased awareness and efforts be given to dementia screenings in various clinical settings.

Keywords: Aging; Alzheimer Disease; Geriatric Assessment; Geriatrics; Mental Status and Dementia Tests.

MeSH terms

  • Aged
  • Cognitive Dysfunction*
  • Dementia* / diagnosis
  • Dementia* / epidemiology
  • Home Care Services*
  • Humans
  • Patient Acceptance of Health Care
  • Prevalence
  • United States / epidemiology