Early presentations of dementia in a diverse population

IF 13 1区医学 Q1 CLINICAL NEUROLOGY

Alzheimer's & Dementia Pub Date : 2025-02-26 DOI:10.1002/alz.14578

Sedigheh Zabihi, Jonathan P Bestwick, Mark Jitlal, Phazha LK Bothongo, Qiqi Zhang, Christine Carter, Moïse Roche, Sarah Morgan-Trimmer, Yvonne Birks, Mark Wilberforce, Ruth Dobson, Alastair J Noyce, John Robson, Fiona M Walter, Claudia Cooper, Charles R Marshall

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Abstract

INTRODUCTION

Improved recognition of non-cognitive presentations of dementia could reduce inequalities in dementia diagnosis, particularly if sociocultural factors influence help-seeking for cognitive symptoms.

METHODS

We conducted a nested case-control study using electronic healthcare records from primary care practices in East London, United Kingdom, to assess associations between prediagnostic presentations to primary care and subsequent dementia diagnosis.

RESULTS

We included 4137 individuals with a dementia diagnosis and 15,754 controls in the matched analysis. In addition to memory difficulties, a range of symptoms were more common in the decade before diagnosis, including depression, anxiety, use of antipsychotics, insomnia, constipation, incontinence, hypotension, hearing loss, imbalance, and dizziness.

DISCUSSION

A range of non-cognitive presentations are seen during the prodromal period of dementia in a diverse population. Improved recognition of these associations and their variation by ethnicity could increase access to dementia diagnosis through improved recognition of early features in people from different sociocultural backgrounds.

Highlights

Prediagnostic signs of dementia include cognitive and non-cognitive symptoms.
Psychiatric symptoms are common up to a decade prior to a dementia diagnosis.
Autonomic prediagnostic symptoms are more common among South Asian groups.
The importance of prediagnostic symptoms of dementia varies by ethnicity.

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来源期刊

Alzheimer's & Dementia 医学-临床神经学

CiteScore

14.50

自引率

5.00%

发文量

299

审稿时长

3 months

期刊介绍： Alzheimer's & Dementia is a peer-reviewed journal that aims to bridge knowledge gaps in dementia research by covering the entire spectrum, from basic science to clinical trials to social and behavioral investigations. It provides a platform for rapid communication of new findings and ideas, optimal translation of research into practical applications, increasing knowledge across diverse disciplines for early detection, diagnosis, and intervention, and identifying promising new research directions. In July 2008, Alzheimer's & Dementia was accepted for indexing by MEDLINE, recognizing its scientific merit and contribution to Alzheimer's research.