Abstract
Introduction: This scoping review aims to identify studies that assess dementia case finding programs (such as memory clinics) on a population basis and specifically assess the impacts that these services have on the diagnosis and management of dementia within a specific population. Methods: We conducted a literature review using the PubMed database, Ovid search engine, and records identified from external sources. This review assessed studies that contained data on patients diagnosed with dementia within a set population, reviewed the impact of specialty services on the diagnosis and management of such patients, and evaluated how this compared to data estimates for that population catchment. Results: The literature review yielded 1106 unique studies, of which only five were determined to be relevant based on the inclusion criteria. There was considerable variation between the primary outcome measures of the five studies included, and a quantitative meta-analysis could not be performed. Discussion: There are currently limited data on the fraction of the total population of people with dementia that are diagnosed and managed by specialised dementia assessment services within a set population. Further studies investigating how these services impact the incidence and prevalence of dementia diagnosis and ongoing management are required.
Highlights
We aim to identify studies that assess dementia case finding programs on a population basis and assess the impacts that these services have on the diagnosis and management of dementia within that population
We aimed to review observational studies that assessed the number of cases of dementia in a set population or catchment, and how the clinics or teams designed to assess for and manage dementia affected the rates of dementia diagnosis and treatment on an ongoing basis
We used the following inclusion criteria: studies that identified diagnoses or management of dementia within a set population, whether patients were reviewed by specialised services for diagnosing and/or managing dementia, were numerical data regarding the diagnosis and/or management of dementia recorded as part of the study, was there a comparison to estimated dementia prevalence within the assessed population, and was an assessment made as to the impact that the specialised services had on the proportion of patients who received a diagnosis of dementia
Summary
This scoping review aims to identify studies that assess dementia case finding programs (such as memory clinics) on a population basis and assess the impacts that these services have on the diagnosis and management of dementia within a specific population. The early detection and management of dementia can help to ease this burden through the timely implementation of appropriate management, and by allowing for arrangements to be made to prolong independence and quality of life before the condition has advanced to a stage where supports are more difficult to implement [2,5,7]. A further complicating factor is the diagnostic uncertainty created due to the often mixed or multifactorial pathologies that can contribute to dementia [7,8,9]. Patient factors contributing to diagnostic difficulty include poor insight into their own cognitive decline, fear of or unwillingness to accept a diagnosis of dementia, and logistical issues with review by an outpatient service that can diagnose dementia due to poor mobility and reduced independence [18,19,20,21]
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