eprintid: 1553357 rev_number: 23 eprint_status: archive userid: 608 dir: disk0/01/55/33/57 datestamp: 2017-04-28 10:22:39 lastmod: 2021-09-26 22:56:11 status_changed: 2017-04-28 10:22:39 type: article metadata_visibility: show creators_name: Lang, L creators_name: Clifford, A creators_name: Wei, L creators_name: Zhang, D creators_name: Leung, D creators_name: Augustine, G creators_name: Danat, IM creators_name: Zhou, W creators_name: Copeland, JR creators_name: Anstey, KJ creators_name: Chen, R title: Prevalence and determinants of undetected dementia in the community: a systematic literature review and a meta-analysis ispublished: pub divisions: UCL divisions: B02 divisions: C08 divisions: D10 divisions: G11 note: This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ abstract: OBJECTIVES: Detection of dementia is essential for improving the lives of patients but the extent of underdetection worldwide and its causes are not known. This study aimed to quantify the prevalence of undetected dementia and to examine its correlates. METHODS/SETTING/PARTICIPANTS: A systematic search was conducted until October 2016 for studies reporting the proportion of undetected dementia and/or its determinants in either the community or in residential care settings worldwide. Random-effects models calculated the pooled rate of undetected dementia and subgroup analyses were conducted to identify determinants of the variation. PRIMARY AND SECONDARY OUTCOME MEASURES: The outcome measures of interest were the prevalence and determinants of undetected dementia. RESULTS: 23 studies were eligible for inclusion in this review. The pooled rate of undetected dementia was 61.7% (95% CI 55.0% to 68.0%). The rate of underdetection was higher in China and India (vs Europe and North America), in the community setting (vs residential/nursing care), age of <70 years, male gender and diagnosis by general practitioner. However, it was lower in the studies using Mini-Mental State Examination (MMSE) diagnosis criteria. CONCLUSIONS: The prevalence of undetected dementia is high globally. Wide variations in detecting dementia need to be urgently examined, particularly in populations with low socioeconomic status. Efforts are required to reduce diagnostic inequality and to improve early diagnosis in the community. date: 2017-02 date_type: published publisher: BMJ PUBLISHING GROUP official_url: http://dx.doi.org/10.1136/bmjopen-2016-011146 oa_status: green full_text_type: pub language: eng primo: open primo_central: open_green article_type_text: Review verified: verified_manual elements_id: 1208420 doi: 10.1136/bmjopen-2016-011146 lyricists_name: Wei, Li lyricists_id: LWEIX32 actors_name: Smith, Daniel actors_id: DSMIT53 actors_role: owner full_text_status: public publication: BMJ Open volume: 7 number: 2 article_number: e011146 pages: 8 issn: 2044-6055 citation: Lang, L; Clifford, A; Wei, L; Zhang, D; Leung, D; Augustine, G; Danat, IM; ... Chen, R; + view all <#> Lang, L; Clifford, A; Wei, L; Zhang, D; Leung, D; Augustine, G; Danat, IM; Zhou, W; Copeland, JR; Anstey, KJ; Chen, R; - view fewer <#> (2017) Prevalence and determinants of undetected dementia in the community: a systematic literature review and a meta-analysis. BMJ Open , 7 (2) , Article e011146. 10.1136/bmjopen-2016-011146 <https://doi.org/10.1136/bmjopen-2016-011146>. Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/1553357/1/e011146.full.pdf document_url: https://discovery.ucl.ac.uk/id/eprint/1553357/7/Lang_Prevalence_determinants_undetected_dementia_Supplementary.pdf