Over- and under-diagnosis of dementia in ethnic minorities: a nationwide register-based study - Nielsen, Vogel, Phung, Gade & Waldemar - 2011 - Article

Is dementia well diagnosed in ethnic minorities?

Some researchers suggest that dementia may be over- and under-diagnosed in ethnic minorities. Some studies found a higher prevalence of dementia in some ethnic minorities, whereas other studies have found that dementia services are not being used optimally by ethnic minorities. Because this has not yet been investigated in European countries, in the current research they will be using data from Danish hospital registers, as it offers a unique opportunity. Denmark has free access to medical care and the pattern of immigration and the history of ethnic minorities are heterogeneous in Western countries.

What has been found out about the prevalence rates of dementia and dementia subtypes in an ethnic minority population?

The mean age of dementia diagnosis was 57.7 years. This was considerably lower compared to patients from the general population, where the mean age was 78.5. The prevalence of dementia rose with increasing age. In the age group of 60 years or older, the prevalence was much lower in both males and females in the ethnic minority population. This indicates that dementia is over-diagnosed in younger ethnic minority populations and highly under-diagnosed in elderly ethnic minority populations. The high prevalence rate in younger age groups could reflect a higher proportion of misdiagnoses in ethnic minority patients. Also because dementia is typically not seen in very young individuals, the validity of such diagnoses seems doubtful.

What could cause over-diagnoses of dementia in younger people?

kelSeveral studies have reported an excess of hypertension, diabetes and cerebrovascular disease in some ethnic minority populations. Some patients may have reacted to these diseases with subjective cognitive complaints. Also, there seems to be an increased incidence of stroke in young adults from ethnic minorities, which could inflate the prevalence of dementia diagnoses.