From suspicion of cognitive decline to dementia diagnosis: a systematic review of healthcare professionals' considerations and attitudes.

Background Initiating diagnostic testing for dementia is a dynamic and complex process that often involves balancing competing interests. This systematic review aims to provide an overview of healthcare professionals' considerations and attitudes during the process from suspicion of cognitive declin...

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Publicado en:Age & Ageing Vol. 54; no. 6; pp. 1 - 17
Autores principales: Visser, Fleur C W, Kloppenburg-Lagendijk, Marleen, Hempenius, Liesbeth, Verwey, Nicolaas A, Perry, Marieke, Eersel, Marlise E A van, Munster, Barbara C van
Formato: Artículo
Publicado: Oxford University Press / USA Jun2025
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Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jun2025
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      pub: Oxford University Press / USA
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        atl: From suspicion of cognitive decline to dementia diagnosis: a systematic review of healthcare professionals' considerations and attitudes.
      aug:
        au:
          Visser, Fleur C W
          Kloppenburg-Lagendijk, Marleen
          Hempenius, Liesbeth
          Verwey, Nicolaas A
          Perry, Marieke
          Eersel, Marlise E A van
          Munster, Barbara C van
        affil:
          Department of Geriatric Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
          Alzheimer Center Groningen, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
          Department of Geriatric Medicine, Medical Center Leeuwarden, Leeuwarden, The Netherlands
          Neurology and Geriatric Department, Medical Center Leeuwarden, Leeuwarden, The Netherlands
          Vrije Universiteit, Amsterdam UMC, Neuroscience Campus, Amsterdam, The Netherlands
          Department of Primary and Community Care, Radboud University Medical Center, Radboudumc Alzheimer Center, Nijmegen, The Netherlands
          Radboud University Medical Center, Radboudumc Alzheimer Center, Nijmegen, The Netherlands
          Department of Geriatric Medicine, Martini Hospital, Groningen, The Netherlands
      su:
        Medical personnel
        Social factors
        Primary health care
        Psychosocial factors
        Cognition disorders diagnosis
        Diagnosis of dementia
        Medical information storage & retrieval systems
        Patients' families
        CINAHL database
        Decision making in clinical medicine
        Primary nursing
        Routine diagnostic tests
        Systematic reviews
        MEDLINE
        Nurse practitioners
        Attitudes of medical personnel
        Disease susceptibility
        Online information services
        Psychology information storage & retrieval systems
      sug:
        subj:
          Medical personnel
          Social factors
          Primary health care
          Psychosocial factors
          Cognition disorders diagnosis
          Diagnosis of dementia
          Medical information storage & retrieval systems
          Patients' families
          CINAHL database
          Decision making in clinical medicine
          Primary nursing
          Routine diagnostic tests
          Systematic reviews
          MEDLINE
          Nurse practitioners
          Attitudes of medical personnel
          Disease susceptibility
          Online information services
          Psychology information storage & retrieval systems
      keyword:
        Alzheimer's disease
        attitudes
        considerations
        decision-making
        diagnosis
        healthcare professionals
        older people
        primary care
        qualitative research
        timely diagnosis
        Alzheimer's disease
        attitudes
        considerations
        decision-making
        diagnosis
        healthcare professionals
        older people
        primary care
        qualitative research
        timely diagnosis
      ab: Background Initiating diagnostic testing for dementia is a dynamic and complex process that often involves balancing competing interests. This systematic review aims to provide an overview of healthcare professionals' considerations and attitudes during the process from suspicion of cognitive decline to deciding to initiate diagnostic testing. Methods Databases (PubMed, EMBASE, CINAHL and PsychINFO) were systematically searched on 29 January 2024 for qualitative and mixed-methods studies published since 2005. Search concepts were: 'dementia', 'considerations and attitudes', 'healthcare professionals' and 'diagnosis'. Two screeners independently conducted title/abstract-screening using ASReview (efficient and transparent systematic review machine learning framework), and full-text screening. Findings were analysed by thematic synthesis. Results Thirty-three studies were included. Most involved primary care physicians (n  = 25), primary care nurses (n  = 1) or a combination (n  = 7). The overarching phenomenon was that starting the diagnostic workup for dementia is a delicate process. Clusters influencing this process were: complexities arising from the nature of dementia; interaction with the patient and family; individual determinants of primary care practitioners (PCPs); expectations regarding the consequences of a diagnosis; factors related to the healthcare system; and societal factors. Together these clusters form PCPs' strategies and actions for deciding whether to start the diagnostic workup. Conclusion Initiating the diagnostic workup for dementia is a delicate process influenced by various factors including fear, reluctance and stigma. The different strategies that PCPs use cannot be captured by a single right approach. Recommendations to better support PCPs in navigating this complex process include ensuring consistent communication and clarity about their roles, and promoting interprofessional collaboration.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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