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Delayed help seeking behavior in dementia care: preliminary findings from the Clinical Pathway for Alzheimer's Disease in China (CPAD) study

Published online by Cambridge University Press:  03 July 2015

Mei Zhao ,
Xiaozhen Lv ,
Maimaitirexiati Tuerxun ,
Jincai He ,
Benyan Luo ,
Wei Chen ,
Kai Wang ,
Ping Gu ,
Weihong Kuang  and
Yuying Zhou
...Show all authors
Mei Zhao
Affiliation:
Dementia Care & Research Center, Peking University Institute of Mental Health (Sixth Hospital); Beijing Municipal Key Laboratory for Translational Research on Diagnosis and Treatment of Dementia, Beijing 100191, China National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital); Key Laboratory for Mental Health, Ministry of Health (Peking University), No. 51 Huayuanbei Road, Beijing 100191, China
Xiaozhen Lv
Affiliation:
Dementia Care & Research Center, Peking University Institute of Mental Health (Sixth Hospital); Beijing Municipal Key Laboratory for Translational Research on Diagnosis and Treatment of Dementia, Beijing 100191, China National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital); Key Laboratory for Mental Health, Ministry of Health (Peking University), No. 51 Huayuanbei Road, Beijing 100191, China
Maimaitirexiati Tuerxun
Affiliation:
Dementia Care & Research Center, Peking University Institute of Mental Health (Sixth Hospital); Beijing Municipal Key Laboratory for Translational Research on Diagnosis and Treatment of Dementia, Beijing 100191, China National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital); Key Laboratory for Mental Health, Ministry of Health (Peking University), No. 51 Huayuanbei Road, Beijing 100191, China Department of Geriatrics, The Fourth People's Hospital of Urumqi, Urumqi 830002, Xinjiang Uygur Autonomous Region, China
Jincai He
Affiliation:
Department of Neurology, The First Affiliated Hospital, Wenzhou Medical College, Wenzhou 325000, Zhejiang Province, China
Benyan Luo
Affiliation:
Department of Neurology, The First Affiliated Hospital of Zhejiang University, Hangzhou 310003, Zhejiang Province, China
Wei Chen
Affiliation:
Department of Psychiatry, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, Zhejiang Province, China
Kai Wang
Affiliation:
Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China
Ping Gu
Affiliation:
Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang 050031, Hebei Province, China
Weihong Kuang
Affiliation:
Mental Health Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Yuying Zhou
Affiliation:
Department of Neurology, Tianjin Huanhu Hospital, Tianjin 300060, China
Qiumin Qu
Affiliation:
Department of Neurology, First Affiliated Hospital of Medical College of Xi’an Jiaotong University, Xi'an 710061, Shanxi Province, China
Jianhua He
Affiliation:
Department of Psychological Medicine, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
Nan Zhang
Affiliation:
Department of Neurology, General Hospital, Tianjin Medical University, Tianjin 300052, China
Yongping Feng
Affiliation:
Department of Geriatric Psychiatry, Shandong Mental Health Center, Jinan 250014, Shandong Province, China
Yanping Wang
Affiliation:
Department of Neurology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, Guangdong Province, China
Xin Yu
Affiliation:
Dementia Care & Research Center, Peking University Institute of Mental Health (Sixth Hospital); Beijing Municipal Key Laboratory for Translational Research on Diagnosis and Treatment of Dementia, Beijing 100191, China National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital); Key Laboratory for Mental Health, Ministry of Health (Peking University), No. 51 Huayuanbei Road, Beijing 100191, China
Huali Wang*
Affiliation:
Dementia Care & Research Center, Peking University Institute of Mental Health (Sixth Hospital); Beijing Municipal Key Laboratory for Translational Research on Diagnosis and Treatment of Dementia, Beijing 100191, China National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital); Key Laboratory for Mental Health, Ministry of Health (Peking University), No. 51 Huayuanbei Road, Beijing 100191, China
*
Correspondence should be addressed to: Dr. Huali Wang at Dementia Care & Research Center, Peking University Institute of Mental Health, No. 51 Huayuanbei Road, Beijing 100191, China. Phone: +86 1082801983. Email: huali_wang@bjmu.edu.cn.
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Abstract

Background:

The prevalence and factors associated with delays in help seeking for people with dementia in China are unknown.

Methods:

Within 1,010 consecutively registered participants in the Clinical Pathway for Alzheimer's Disease in China (CPAD) study (NCT01779310), 576 persons with dementia (PWDs) and their informants reported the estimated time from symptom onset to first medical visit seeking diagnosis. Univariate analysis of general linear model was used to examine the potential factors associated with the delayed diagnosis seeking.

Results:

The median duration from the first noticeable symptom to the first visit seeking diagnosis or treatment was 1.77 years. Individuals with a positive family history of dementia had longer duration (p = 0.05). Compared with other types of dementia, people with vascular dementia (VaD) were referred for diagnosis earliest, and the sequence for such delays was: VaD < Alzheimer's disease (AD) < frontotemporal dementia (FTD) (p < 0.001). Subtypes of dementia (p < 0.001), family history (p = 0.01), and education level (p = 0.03) were associated with the increased delay in help seeking.

Conclusions:

In China, seeking diagnosis for PWDs is delayed for approximately 2 years, even in well-established memory clinics. Clinical features, family history, and less education may impede help seeking in dementia care.

Keywords

dementiaduration of delayhelp-seeking behavior
Type
Research Article
Information
International Psychogeriatrics , Volume 28 , Issue 2 , February 2016 , pp. 211 - 219
Copyright
Copyright © International Psychogeriatric Association 2015 

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