The pathway to dementia diagnosis

OBJECTIVE: To describe the steps taken by health professionals to diagnose dementia and the timeframes for these steps, as reported by carers. DESIGN, SETTING AND PARTICIPANTS: A cross-sectional, anonymous survey was mailed or distributed by Alzheimer's Australia New South Wales, six Sydney residential aged care facilities and 13 Sydney general practitioners to 415 carers or family members of patients with dementia between May and August 2007. MAIN OUTCOME MEASURES: First symptoms noticed and actions taken; time to first health professional consultation and diagnosis; reported actions of first health professional; satisfaction with first consultation; and use of dementia and chronic illness resources. RESULTS: 209 surveys were returned. Family members noticed the first symptoms of dementia at a mean of 1.9 years before the first health professional consultation about dementia, and 3.1 years before a firm diagnosis. Resource use first occurred 2.8 years after the first symptoms. Most carers (72%) were satisfied with the first consultation, which was usually with a GP (84%). Two-thirds of carers (64%) reported that the first health professional had performed a memory test. CONCLUSIONS: Delays in presentation, diagnosis and resource use may have clinical and social implications for people with dementia and their families, in addition to the challenges of the process of obtaining a firm diagnosis.