Delayed dementia diagnosis ups danger potential

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Halima Amjad, M.D., M.P.H.
Halima Amjad, M.D., M.P.H.

Older adults who show signs of probable dementia but have not received a formal diagnosis are almost twice as likely as those who have received a diagnosis to undertake activities — such as driving, cooking and managing finances and medications — that could endanger themselves and others.

That's according to the results of a study published in the June issue of the Journal of the American Geriatrics Society, which the authors say highlight the potential benefits of formal diagnosis as early as possible.

“When patients receive a formal dementia diagnosis, their families are typically aware that, at some point, their loved ones will not be able to drive or will need more help with their medicine,” said study leader Halima Amjad, M.D., M.P.H., a fellow in the Johns Hopkins University School of Medicine's Division of Geriatric Medicine and Gerontology. “But when people are undiagnosed, families and friends may ignore or be unaware of functional problems that already exist.”

Amjad and colleagues reviewed data from about 7,600 older adults participating in the National Health and Aging Trends Study. Participants in the study, begun in 2011, are interviewed periodically and undergo cognitive and physical tests to assess their health as they age.

Their analysis showed that those with dementia, either diagnosed or undiagnosed (but probable, based on test results), were less frequently participating in potentially unsafe activities than those with possible or no dementia. “That in itself is good news, though the numbers are still important from a public health and safety standpoint,” Amjad said. “Either the patients themselves or their family members are self-regulating and doing these activities less frequently as their disease is progressing.”

The study, however, also revealed that those whose dementia was undiagnosed (but probable, based on test results) were significantly more likely to be undertaking unsafe activities compared with those with a formal dementia diagnosis.

For instance:

  • Almost 28% of the study participants with undiagnosed dementia were still driving, compared with 17% of those with diagnosed dementia.
  • About 29% of those with undiagnosed dementia were still handling their finances, compared with 12% of those with diagnosed dementia.
  • About 42% of those with undiagnosed dementia were still preparing hot meals for themselves, compared with about 17% of those with diagnosed dementia.
  • About 50% of those with undiagnosed dementia were still handling their medications, compared with almost 22% of those with diagnosed dementia.

The findings should be a wake-up call to those who care for the elderly and family members whose loved ones might be developing the condition, Amjad said.

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