Many Older Americans May Have Dementia Diagnoses Without Knowing

A study by Yale University researchers reveals that a significant number of older Americans may have dementia diagnoses they are unaware of or do not disclose to healthcare providers. The study found that 67% of the participants underreported having a dementia diagnosis, a rate more than double that of other conditions. The most common conditions that older adults underreported were hypertension (23%), arthritis (17%), diabetes (39%), and depression (46%).

The lead author, Xi Chen, suggests that dementia is often a stigmatized diagnosis, leading to concealment by patients or inadequate communication from clinicians. The study, published in JAMA, highlights the importance of clear communication and support in ensuring patients understand their diagnosis, as this can lead to better care planning, increased safety, and improved engagement in disease management.

Chen notes that the magnitude of underreporting is concerning, especially given the growing awareness of dementia risk factors and emerging treatments. Improving dementia detection is crucial, but equally important is ensuring patients understand their diagnosis, as this can impact their ability to make decisions about finances, safety, driving, legal affairs, and treatment preferences.

The study also points to specific groups of patients who are more likely to underreport their diagnosis, including those enrolled in Medicare Advantage, those who see dementia specialists, and those diagnosed in outpatient settings. Patients living alone, with lower education levels, dual Medicare-Medicaid eligibility, and African American adults were also more likely to underreport.

Addressing the stigma surrounding dementia is essential to encourage people to accept diagnoses and access available support.