Kusoro Olubunmi, Roche Moïse, Del-Pino-Casado Rafael, Leung Phuong, Orgeta Vasiliki
Faculty of Brain Sciences, Division of Psychiatry, University College London, London, UK.
Faculty of Health Sciences, Department of Nursing, University of Jaén, Andalusia, Spain.
Int J Geriatr Psychiatry. 2025 Jul;40(7):e70129. doi: 10.1002/gps.70129.
Timely dementia diagnosis is a global priority, reflected in most national and regional policies and plans. Nevertheless, there are currently no robust estimates of the average time to diagnosis (TTD) and factors influencing diagnostic intervals. This article presents the first systematic review of quantitative studies on TTD in dementia and the factors associated with its duration. We systematically searched EMBASE, Psych INFO, MEDLINE, and CINAHL databases for relevant studies published up to December 2024. We defined TTD as the interval between symptom onset (rated by family carers or patients using interviews or medical records) to final diagnosis. Risk of bias was assessed using the Reporting studies on time to diagnosis tool. We included 13 studies reporting data on 30,257 participants, with age at onset ranging between 54 and 93 years. Meta-analysis pooling 10 studies showed that average mean TTD across all types of dementia was 3.5 years [confidence interval (CI): 2.7-4.3; moderate quality evidence]. Analyses of six studies showed that TTD in young onset dementia was 4.1 years (CI: 3.4-4.9; moderate quality evidence). Although the factors influencing TTD were inconsistent, a younger age at onset and having frontotemporal dementia were consistently associated with a longer interval to diagnosis. TTD in dementia remains long, and specific healthcare strategies are urgently needed to improve it. Increasing the evidence base and developing interventions to reduce TTD should be a future research priority. Specialist services are likely to be key in improving TTD in young-onset dementia.
及时诊断痴呆症是全球的一项优先任务，这在大多数国家和地区的政策及计划中都有所体现。然而，目前尚无对平均诊断时间（TTD）以及影响诊断间隔因素的可靠估计。本文首次对痴呆症TTD的定量研究及其持续时间相关因素进行了系统综述。我们系统检索了EMBASE、Psych INFO、MEDLINE和CINAHL数据库，以查找截至2024年12月发表的相关研究。我们将TTD定义为症状出现（由家庭护理人员或患者通过访谈或病历评定）至最终诊断之间的间隔。使用诊断时间报告研究工具评估偏倚风险。我们纳入了13项报告30257名参与者数据的研究，发病年龄在54至93岁之间。对10项研究进行的荟萃分析表明，所有类型痴呆症患者的平均TTD为3.5年[置信区间（CI）：2.7 - 4.3；中等质量证据]。对6项研究的分析表明，早发性痴呆症患者的TTD为4.1年（CI：3.4 - 4.9；中等质量证据）。尽管影响TTD的因素并不一致，但发病年龄较轻和患有额颞叶痴呆症始终与更长的诊断间隔相关。痴呆症的TTD仍然很长，迫切需要制定具体的医疗保健策略来加以改善。增加证据基础并开发减少TTD的干预措施应是未来的研究重点。专科服务可能是改善早发性痴呆症TTD的关键。
