Prevalence and correlates of potentially undetected dementia among residents of institutional care facilities in Ontario, Canada, 2009–2011
- 4 February 2013
- journal article
- research article
- Published by Wiley in International Journal of Geriatric Psychiatry
- Vol. 28 (10), 1086-1094
- https://doi.org/10.1002/gps.3934
Abstract
Objectives This study aims to determine the prevalence of potentially undetected dementia among institutional care facility residents in Ontario, Canada, and to identify factors associated with undetection. Methods We utilized a population-based secondary data analysis approach, pertaining to data from the Canadian Institute for Health Information's Continuing Care Reporting System, 2009–2011. Potentially undetected dementia was defined as having severely impaired cognitive function and requiring extensive assistance on activity of daily living (ADL) but no records of dementia diagnoses. Cognitive function was measured by the Cognitive Performance Scale (CPS), 0 (intact) to 6 (very severe impairment), and ADL by a hierarchy scale, 0 (independent) to 6 (total dependence). Results Of the 242,957 residents who had no records of dementia diagnoses, 11.6% (n = 28,078) had a CPS score ≥4 (severe impairment or higher) and ADL score ≥3 (required extensive assistance or more). Data from 11,614 demented residents with corresponding CPS and ADL scores were used for comparison. Residents without dementia diagnosis were younger (77 vs. 84 years), more likely to have never married (20% vs. 6%), and have longer admission (4 vs. 2.8 years). The most significant factors for no diagnoses were never married (adjusted odds ratio = 2.1, 95% confidence interval [CI] = 1.91–2.29), admitted to hospital-based facilities (adjusted odds ratio = 1.58, 95% CI = 1.48–1.69), presence of schizophrenia (adjusted odds ratio = 1.43, 95% CI = 1.22–1.69), depression (adjusted odds ratio = 1.23, 95% CI = 1.16–1.29), and diabetes mellitus (adjusted odds ratio = 1.32, 95% CI = 1.26–1.40). Conclusions A large number of residents who had poor cognitive function and inadequate ADL ability did not have dementia diagnoses on record. Social and comorbid conditions were contributing factors to potentially undetected dementia. Copyright © 2013 John Wiley & Sons, Ltd.Keywords
This publication has 50 references indexed in Scilit:
- Assessment scales in dementiaTherapeutic Advances in Neurological Disorders, 2012
- Temporal and Geographic variation in the validity and internal consistency of the Nursing Home Resident Assessment Minimum Data Set 2.0BMC Health Services Research, 2011
- Rapid appraisal of barriers to the diagnosis and management of patients with dementia in primary care: a systematic reviewBMC Family Practice, 2010
- The Resident Assessment Instrument-Minimum Data Set 2.0 quality indicators: a systematic reviewBMC Health Services Research, 2010
- Missed and Delayed Diagnosis of Dementia in Primary CareAlzheimer Disease & Associated Disorders, 2009
- Detection and Management of Pre-existing Cognitive Impairment and Associated Behavioral Symptoms in the Intensive Care UnitCritical Care Clinics, 2008
- Psychiatric illness delays diagnosis of esophageal cancerDiseases of the Esophagus, 2008
- Measuring primary care patients' attitudes about dementia screeningInternational Journal of Geriatric Psychiatry, 2008
- Detecting Dementia With the Mini-Mental State Examination in Highly Educated IndividualsArchives of Neurology, 2008
- Comparison of the diagnostic accuracy of the Cognitive Performance Scale (Minimum Data Set) and the Mini‐Mental State Exam for the detection of cognitive impairment in nursing home residentsInternational Journal of Geriatric Psychiatry, 2006