Gjøra Linda, Strand Bjørn Heine, Bergh Sverre, Bosnes Ingunn, Johannessen Aud, Livingston Gill, Skjellegrind Håvard Kjesbu, Selbæk Geir
The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.
Department of Psychiatry, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway.
J Alzheimers Dis. 2024;99(1):363-375. doi: 10.3233/JAD-240037.
A timely diagnosis of dementia can be beneficial for providing good support, treatment, and care, but the diagnostic rate remains unknown and is probably low.
To determine the dementia diagnostic rate and to describe factors associated with diagnosed dementia.
This registry linkage study linked information on research-based study diagnoses of all-cause dementia and subtypes of dementias, Alzheimer's disease, and related dementias, in 1,525 participants from a cross-sectional population-based study (HUNT4 70+) to dementia registry diagnoses in both primary-care and hospital registries. Factors associated with dementia were analyzed with multiple logistic regression.
Among those with research-based dementia study diagnoses in HUNT4 70+, 35.6% had a dementia registry diagnosis in the health registries. The diagnostic rate in registry diagnoses was 19.8% among home-dwellers and 66.0% among nursing home residents. Of those with a study diagnosis of Alzheimer's disease, 35.8% (95% confidence interval (CI) 32.6-39.0) had a registry diagnosis; for those with a study diagnosis of vascular dementia, the rate was 25.8% (95% CI 19.2-33.3) and for Lewy body dementias and frontotemporal dementia, the diagnosis rate was 63.0% (95% CI 48.7-75.7) and 60.0% (95% CI 43.3-75.1), respectively. Factors associated with having a registry diagnosis included dementia in the family, not being in the youngest or oldest age group, higher education, more severe cognitive decline, and greater need for help with activities of daily living.
Undiagnosed dementia is common, as only one-third of those with dementia are diagnosed. Diagnoses appear to be made at a late stage of dementia.
及时诊断痴呆症有助于提供良好的支持、治疗和护理，但诊断率仍然未知且可能较低。
确定痴呆症诊断率并描述与确诊痴呆症相关的因素。
这项登记链接研究将基于研究的全因痴呆症及痴呆症亚型、阿尔茨海默病和相关痴呆症的诊断信息，从一项基于人群的横断面研究（HUNT4 70+）中的1525名参与者，与初级保健和医院登记处的痴呆症登记诊断信息进行了链接。使用多元逻辑回归分析与痴呆症相关的因素。
在HUNT4 70+中基于研究诊断为痴呆症的人群中，35.6%在健康登记处有痴呆症登记诊断。登记诊断在家居者中的诊断率为19.8%，在养老院居民中为66.0%。在研究诊断为阿尔茨海默病的人群中，35.8%（95%置信区间（CI）32.6 - 39.0）有登记诊断；研究诊断为血管性痴呆的人群中，这一比例为25.8%（95% CI 19.2 - 33.3），路易体痴呆和额颞叶痴呆的诊断率分别为63.0%（95% CI 48.7 - 75.7）和60.0%（95% CI 43.3 - 75.1）。与有登记诊断相关的因素包括家族中有痴呆症、不在最年轻或最年长年龄组、高等教育、更严重的认知衰退以及在日常生活活动中更需要帮助。
未诊断出的痴呆症很常见，因为只有三分之一的痴呆症患者被诊断出来。诊断似乎是在痴呆症的晚期进行的。
