Early Diagnosis of Cognitive Impairment in the Ageing Population: Determinants and Barriers

Diagnosis of cognitive impairment at an early stage is vital to the management of dementias like Alzheimer's disease. Recent studies have proven the benefits of multimodal interventions in patients with early stages of cognitive impairment. In this study, we evaluate the determinants of presentation of cognitive impairment at early and late stages in a tertiary center memory clinic.

A cross-sectional study.

A total of 438 patients presenting with cognitive impairment were evaluated in the memory clinic. After ruling out reversible causes and pseudodementia, 294 patients were included for final analysis and classified as those with early disease (i.e., Subjective Cognitive Decline [SCD] and Mild Cognitive Impairment [MCI]) or major neurocognitive decline [MNCD]. A retrospective data analysis was done to evaluate the association of baseline characteristics (age, sex, education, region, occupation, and cardiovascular diseases) with the stage of presentation of cognitive decline.

Patients presenting with an early-stage cognitive impairment (SCD and MCI) constituted 65% and MNCD was identified in 35% of the population. Demographic factors like female sex [OR: 1.99, 95% CI: 1.10, 3.56] and lower education [OR: 1.99, 95% CI: 1.15, 3.42] were significantly associated with late presentation MNCD.

Female patients and those with lower education are vulnerable to late presentation and can be an important target population for dementia screening. Increasing dementia awareness and care at the primary healthcare level may help in the early diagnosis and preventive interventions of dementia.