Observational studyJournal of general internal medicine2018
Underdiagnosis of Dementia: an Observational Study of Patterns in Diagnosis and Awareness in US Older Adults.
Observational study in Journal of general internal medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 312 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
312 citing papers in PubMed, 4 syntheses or guidelines pooled it, 478 citations in OpenAlex.
- Electronic health record-based prediction models for dementia detection: a systematic review of model performance and quality.Journal of the American Medical Informatics Association : JAMIA · 2026Pooled it
- The Italian guideline on diagnosis and treatment of dementia and mild cognitive impairment.Age and ageing · 2024Guideline
- Palliative Care in Early Dementia.Journal of pain and symptom management · 2024Pooled it
- Understanding barriers to and facilitators of clinician-patient conversations about brain health and cognitive concerns in primary care: a systematic review and practical considerations for the clinician.BMC primary care · 2023Pooled it
- Adaptive pathways for multimodal community-based detection of cognitive impairment: the CogScreen I study.Scientific reports · 2026Trial
- Longitudinal Evaluation of the HABC Monitor Among Trauma Survivors.Clinical interventions in aging · 2025Trial
- Sharing health care wishes among older adults with cognitive impairment in primary care: Results from a randomized controlled trial.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2024Trial
- Utility of the Healthy Aging Brain Care Monitor as a Patient-Reported Symptom Monitoring Tool in Older Injury Survivors.The Journal of surgical research · 2023Trial
- Associations of Individual- and Neighborhood-Level Factors with Racial and Ethnic Disparities in Timely Dementia Diagnosis.Journal of general internal medicine · 2026Observational
- The value of timely treatment with anti-amyloid therapy for Alzheimer's disease.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Article
- Clinical Group Assignment in Home Health Care for Medicare Beneficiaries With ADRD: A 2019 Pre-PDGM Simulation.Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2026Article
- What Increases the Likelihood of Dementia Among Asian Americans? Analysis of Nativity and Life Course Factors.Journal of racial and ethnic health disparities · 2026Article
- Article
- Perceptions of Alzheimer's Disease Among Cognitively Healthy, Community-Dwelling Older Adults: A Metaphor Study.Psychogeriatrics : the official journal of the Japanese Psychogeriatric Society · 2026Article
- Comparison of Claims-Based Algorithms for Dementia Identification: A Cross-Sectional Analysis of the National Health and Aging Trends Study (NHATS).Journal of the American Geriatrics Society · 2026Article
- Dementia Diagnosis Underreporting and Care Engagement and Planning Among Older Adults.JAMA network open · 2026Article
- Assigning Probable Dementia Status Using Routinely Collected Electronic Health Record Data.Journal of the American Geriatrics Society · 2026Article
- Major Adverse Cognitive Events (MACE-Cog): A New "MACE" Framework for Cognitive Outcomes in Cardiovascular Diseases and Stroke.Circulation · 2026Review
- Adoption of Alzheimer's disease biomarkers by primary care clinicians: findings from the National Dementia Workforce Study.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Article
- Increased dementia diagnosis and workup in primary care with a bilingual screening tool integrated in the electronic health record.Journal of Alzheimer's disease : JAD · 2026Article
252 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundMany older adults living with dementia have not been formally diagnosed. Even when clinicians document the diagnosis, patients and families may be unaware of the diagnosis. Knowledge of how individual characteristics affect detection and awareness of dementia is limited.
objectiveTo identify characteristics associated with dementia diagnosis and awareness of diagnosis.
designCross-sectional observational study.
participantsFive hundred eighty-five adults aged ≥ 65 in the National Health and Aging Trends Study who met assessment-based study criteria for probable dementia in 2011 and had 3 years of continuous, fee-for-service Medicare claims prior to 2011. MAIN MEASURES: Using multivariable logistic regression, we compared participants with undiagnosed versus diagnosed dementia (based on Medicare claims) on demographic, social/behavioral, functional, medical, and healthcare utilization characteristics. Among those diagnosed, we compared characteristics of participants unaware versus aware of the diagnosis (based on self or proxy report). KEY
resultsAmong older adults with probable dementia, 58.7% were either undiagnosed (39.5%) or unaware of the diagnosis (19.2%). In adjusted analyses, individuals who were Hispanic (OR 2.48, 95% CI 1.19, 5.14), had less than high school education (OR 0.54 for at least high school education, 95% CI 0.32, 0.91), attended medical visits alone (OR 1.98, 95% CI 1.11, 3.51), or had fewer functional impairments (OR 0.79 for each impairment, 95% CI 0.69, 0.90) were more likely to be undiagnosed. Similarly, among those diagnosed, having less education (OR 0.42), attending medical visits alone (OR 1.97), and fewer functional impairments (OR 0.72) were associated with unawareness of diagnosis (all ps < 0.05).
conclusionsThe majority of older adults with dementia are either undiagnosed or unaware of the diagnosis, suggesting shortcomings in detection and communication of dementia. Individuals who may benefit from targeted screening include racial/ethnic minorities and persons who have lower educational attainment, any functional impairment, or attend medical visits alone.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.