New study examines the diagnostic pathway for patients with cognitive impairment

We are pleased to summarise findings from a new publication from the Centre for Dementia Prevention. Prof Craig Ritchie and international colleagues pooled real-world data from across seven European and North American Countries to assess the diagnostic pathway for patients with cognitive impairment. The study found that cognitive impairment is commonly not diagnosed at the earliest stages of the disease and efforts should be made towards public awareness and earlier disease detection and intervention.

Recent advances in our understanding of Alzheimer’s disease mean that we now know Alzheimer’s dementia is a syndrome that manifests at later life but the underlying reason for the syndrome, Alzheimer’s disease, starts developing years before any symptoms occur. This has led to looking at brain health related diseases – neurodegenerative disease – on a spectrum. Cognitive impairment includes a wide range and severity of conditions and for many patients may result in the onset of dementia. It is important to identify cognitive impairment at an early stage where intervention would have the most impact at being effective in preventing further cognitive decline. The diagnostic pathway for receiving a formal diagnosis of dementia should therefore enable an early identification of the at risk population.

The authors of the new study analysed real-world cross-sectional survey data from seven European and North American Countries to quantify the diagnostic pathway for dementia. The study included 7620 patients with cognitive impairment. The study found that most patients saw a healthcare professional within 1 year of first symptoms and received a diagnosis within 3–7 months of initial consultation. However, only 20% of patients received a diagnosis before their disease progressed beyond the early stage and 23.5% already had moderate cognitive impairment at time of diagnosis. The paper concludes that only a small minority of patients receive an early stage diagnosis of cognitive impairment – this necessitates a focus on public awareness and a proactive earlier detection and intervention in order to increase the proportion of patients who receive comprehensive medical and psychosocial support before their disease progresses to levels associated with significant impact on their lives and their families.