Facilitators and Barriers to Dementia Assessment and Diagnosis: Perspectives From Dementia Experts Within a Global Health Context
Front Neurol. 2022 Mar 28;13:769360. doi: 10.3389/fneur.2022.769360. eCollection 2022.
ABSTRACT
OBJECTIVES: Dementia poses one of the greatest global health challenges, affecting 50 million people worldwide. With 10 million new cases each year, dementia is a growing burden, particularly in low- and middle-income countries (LMIC). This study aimed to identify the facilitators and barriers to providing quality dementia assessment and care in LMICs from a global health perspective.
METHODS/DESIGN: A qualitative semi-structured interview study with 20 dementia expert healthcare providers from 19 countries. To be included, providers had to: practice dementia assessment or care in LMICs where the population over age 60 is projected to more than double by 2050 and be recognized as a leading dementia expert in the region based on position, research publications, and/or policy leadership. Interviews were analyzed by a multidisciplinary team of researchers using thematic analysis.
RESULTS: Barriers to dementia assessment and care included stigma about dementia, poor patient engagement in and access to healthcare, inadequate linguistic and cultural validation, limited dementia capable workforce, competing healthcare system priorities, and insufficient health financing. Facilitators included the rise in dementia awareness campaigns, dementia training for general practitioners, availability of family support and family caregivers, and national and international collaborations including coordinated policy efforts and involvement in international research initiatives.
CONCLUSIONS: Findings from this study provide insights for prioritizing dementia assessment and care capacity-building in LMICs as a global health priority and for tailored public health approaches to strengthen dementia assessment and care at the individual, community, national, and multi-national levels.
PMID:35418934 | PMC:PMC8997042 | DOI:10.3389/fneur.2022.769360
Authors
![Alissa Bernstein](/sites/default/files/styles/image_1x1_small/public/profile/alissa_bernstein.jpg?h=bade9c6d&itok=rPEdJAXY)
Alissa Bernstein, PhD, MPH, MA
Medical Anthropologist, Assistant Professor
![Tala Al-rousan](/sites/default/files/styles/image_1x1_small/public/profile/Tala-Al-rousan.jpg?h=8e5669b2&itok=E19s5aVY)
Tala Al-Rousan, MD, MPH
Epidemiologist
![Elena Tsoy](/sites/default/files/styles/image_1x1_small/public/profile/Elena%20Tsoy%20RSZ.jpeg?h=5e947002&itok=LNQS5Bim)
Elena Tsoy, PhD
Clinical Neuropsychologist
![Stefanie Pina Escudero 2023](/sites/default/files/styles/image_1x1_small/public/profile/GBHI_2023-Conference-Photos_125%20%281%29%20%281%29.jpg?h=301bf149&itok=H795CwKR)
Stefanie Piña Escudero, MD
Geriatrician
![Maritza Pintado-Caipa](/sites/default/files/styles/image_1x1_small/public/profile/Foto.jpeg?h=7866ebfa&itok=LOeycjW_)
Maritza Pintado-Caipa, MD
Neurologist
![Lingani Mbakile-Mahlanza](/sites/default/files/styles/image_1x1_small/public/profile/lingani_mbakile-mahlanza.jpg?h=ea75faf3&itok=reek7-Gp)
Lingani Mbakile Mahlanza, DPsyc
Clinical Neuropsychologist
![Maira Okada de Oliveira](/sites/default/files/styles/image_1x1_small/public/profile/maira_okada_de_oliveira.jpg?h=6846fd67&itok=NL4UrZlN)
Maira Okada de Oliveira, PhD
Neuropsychologist
![Myriam De la Cruz Puebla](/sites/default/files/styles/image_1x1_small/public/profile/Myriam_DeLaCruzPuebla.jpeg?h=c9c963d4&itok=9zbDkqXK)
Myriam De la Cruz Puebla, MD, PhDc
Neurologist & Scientist
![Stelios Zygouris](/sites/default/files/styles/image_1x1_small/public/profile/Stelios%20Zygouris.jpg?h=e1036815&itok=LjhiEaC4)
Stelios Zygouris, PhD
Neuropsychologist
![Aya Ashour](/sites/default/files/styles/image_1x1_small/public/profile/Aya%20Ashour.jpg?h=b988a365&itok=rrXpoH9R)
Aya Ashour, MD, PhD
Clinical & Academic Neurologist
![Hany Ibrahim](/sites/default/files/styles/image_1x1_small/public/profile/Hany%20Ibrahim.jpg?h=97d83ba5&itok=zPqDGeuf)
Hany Ibrahim, MD, MSc, PhD
Consultant Geriatrician, Senior Lecturer
![Bruce Miller](/sites/default/files/styles/image_1x1_small/public/profile/Bruce%20Miller.jpg?h=3334e0bf&itok=3zITuREU)
Bruce Miller, MD
Founding Director, University of California, San Francisco
![Victor Valcour](/sites/default/files/styles/image_1x1_small/public/profile/Victor%20Valcour.jpg?h=88b1f798&itok=-hX5KIpa)
Victor Valcour, MD, PhD
Site Director, University of California, San Francisco
![Kate Possin](/sites/default/files/styles/image_1x1_small/public/profile/Kate-Possin.jpg?h=b17e2d09&itok=N7EpTTfi)
Kate Possin, PhD
Professor of Neurology