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63/100

✓ Peer-reviewed alzhub usefulness score 63 out of 100. Getting a diagnosis

Topic: Risk, prevention and care in population studies

Background Many older adults living with dementia have not been formally diagnosed. Even when clinicians document the diagnosis, patients and families may be unaware of the diagnosis. Knowledge of how individual characteristics affect detection and awareness of dementia is limited. Objective To identify characteristics associated with dementia diagnosis and awareness of diagnosis. Design Cross-sectional observational study. Participants Five hundred eighty-five adults aged ≥ 65 in the National Health and Aging Trends Study who met assessment-based study criteria for probable dementia in 2011 and had 3 years of continuous, fee-for-service Medicare claims prior to 2011. Main measures Using multivariable logistic regression, we compared participants with undiagnosed versus diagnosed dementia (based on Medicare claims) on demographic, social/behavioral, functional, medical, and healthcare utilization characteristics. Among those diagnosed, we compared characteristics of participants unaware versus aware of the diagnosis (based on self or proxy report). Key results Among older adults with probable dementia, 58.7% were either undiagnosed (39.5%) or unaware of the diagnosis (19.2%). In adjusted analyses, individuals who were Hispanic (OR 2.48, 95% CI 1.19, 5.14), had less than high school education (OR 0.54 for at least high school education, 95% CI 0.32, 0.91), attended medical visits alone (OR 1.98, 95% CI 1.11, 3.51), or had fewer functional impairments (OR 0.79 for each impairment, 95% CI 0.69, 0.90) were more likely to be undiagnosed. Similarly, among those diagnosed, having less education (OR 0.42), attending medical visits alone (OR 1.97), and fewer functional impairments (OR 0.72) were associated with unawareness of diagnosis (all ps Conclusions The majority of older adults with dementia are either undiagnosed or unaware of the diagnosis, suggesting shortcomings in detection and communication of dementia. Individuals who may benefit from targeted screening include racial/ethnic minorities and persons who have lower educational attainment, any functional impairment, or attend medical visits alone.

Cite this study APA, Vancouver, BibTeX · download .bib or .ris

APA 7th

Amjad, H., Roth, D. L., Sheehan, O. C., Lyketsos, C. G., Wolff, J. L., & Samus, Q. M. (2018). Underdiagnosis of Dementia: an Observational Study of Patterns in Diagnosis and Awareness in US Older Adults. Journal of general internal medicine. https://doi.org/10.1007/s11606-018-4377-y

Vancouver

Amjad H, Roth DL, Sheehan OC, Lyketsos CG, Wolff JL, Samus QM. Underdiagnosis of Dementia: an Observational Study of Patterns in Diagnosis and Awareness in US Older Adults. Journal of general internal medicine. 2018. doi:10.1007/s11606-018-4377-y. PMID: 29508259.

BibTeX

@article{amjad2018-29508259,
  author  = {Amjad, H. and Roth, D. L. and Sheehan, O. C. and Lyketsos, C. G. and Wolff, J. L. and Samus, Q. M.},
  title   = {{Underdiagnosis of Dementia: an Observational Study of Patterns in Diagnosis and Awareness in US Older Adults}},
  journal = {Journal of general internal medicine},
  year    = {2018},
  doi     = {10.1007/s11606-018-4377-y},
  pmid    = {29508259},
  url     = {https://doi.org/10.1007/s11606-018-4377-y}
}

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Key findings

Objective To identify characteristics associated with dementia diagnosis and awareness of diagnosis.
Main measures Using multivariable logistic regression, we compared participants with undiagnosed versus diagnosed dementia (based on Medicare claims) on demographic, social/behavioral, functional, medical, and healthcare utilization characteristics.
Among those diagnosed, we compared characteristics of participants unaware versus aware of the diagnosis (based on self or proxy report).
Key results Among older adults with probable dementia, 58.7% were either undiagnosed (39.5%) or unaware of the diagnosis (19.2%).
Similarly, among those diagnosed, having less education (OR 0.42), attending medical visits alone (OR 1.97), and fewer functional impairments (OR 0.72) were associated with unawareness of diagnosis (all ps < 0.05).

Why it matters

In a 2011 sample of 585 US adults aged 65+ on fee-for-service Medicare who met survey criteria for probable dementia, 39.5% had no dementia diagnosis in their Medicare claims and another 19.2% had one but were reported as unaware of it, 58.7% in all. Being Hispanic, having less than high school education, attending medical visits alone and having fewer functional impairments were each associated with being undiagnosed, and the last three also with being unaware. These are associations from a single snapshot; the authors suggest these groups "may benefit from targeted screening", which the study did not test.

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Study details

Study designcross-sectional
Effect size58.7%; 39.5%; 19.2%
Evidence strengthLow

How this study scored 63/100

Published in a peer-reviewed journal, and it is a snapshot of people at one point in time. Scored zero for sample size and randomized / blinded because the record does not state it.

Component	Points	Why
Journal tier	7 / 10	Tier 3 — peer-reviewed journal (Journal of general internal medicine)
Journal's citation record	3 / 4	Journal of General Internal Medicine: journal h-index 283 (OpenAlex, 2026-10-29)
Study design	4 / 12	A snapshot of people at one point in time
Strength of evidence	1 / 5	Rated “low” in our summary
Peer-review validation	10 / 10	Peer-reviewed. Published as an article in a named peer-reviewed journal.
How recent	2 / 5	2018 — within 10 year(s) of the newest study here
Sample size	0 / 4	Participant count not stated — scores zero (not stated in the record — scored 0)
Effect reported	2 / 3	Effect reported as a number, without an interval or test
Studied in people	3 / 3	Studied in people (pubmed indexes it as a clinical or observational study)
Randomized / blinded	0 / 2	No randomization or blinding stated — scores zero (not stated in the record — scored 0)
Times cited	6 / 7	Cited 504 times (OpenAlex, 2026-10-10)
Citations per year	5 / 5	50.4 citations a year over 10 year(s) since 2018
Impact for its field and year	5 / 6	Cited 27.3× the average for papers of its field and year (OpenAlex FWCI)
Cited by studies here	4 / 6	Cited by 39 other studies in this library
Still being cited	4 / 4	Cited 213 times in 2024–2026 (2026 still in progress; OpenAlex)
Senior author's track record	2 / 4	Last-listed author Quincy Miles Samus: h-index 32 (OpenAlex, whole career)
Institution's track record	2 / 3	Johns Hopkins University: institution h-index 2,306 (OpenAlex)
Multicenter collaboration	1 / 3	OpenAlex lists 2 institution(s) in 1 country
Indexed in PubMed	2 / 2	Indexed in PubMed (PMID 29508259)
Free to read	0 / 2	Behind a paywall — scores zero
Total	63 / 100	—

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