Underrecognition of Dementia by Caregivers Cuts Across Cultures-Reply

Abstract

In Reply. —Dr Snowdon and colleagues, 1 in their report of silent dementia among elderly Catholic sisters of European descent, provide important corroboration of our findings in Japanese-American men living in Hawaii. In both studies, 21% to 22% of caregivers failed to recognize signs of dementia among subjects with clinically diagnosed dementia. These nearly identical results are striking considering the many differences between the populations and the fact that the informants in the Nun Study were professional caregivers. This suggests that difficulty in recognizing dementia in elderly people is a common problem that crosses cultural and gender boundaries. Equally interesting is their observation that caregivers labeled 16% of the participants as demented when dementia was not present. Similarly, we found 15 (13%) of 116 nondemented elderly Japanese-American men had family informants who said they had a definite problem with thinking or memory. We appreciate Dr Antonelli Incalzi and colleagues bringing to our