Aims: Diagnosis of Alzheimer’s Dementia (AD) at a later stage can preclude patients from the opportunity to fully participate in post-diagnostic programs, clinical trials, future planning and to access emerging treatments. This study investigated the prevalence and factors associated with diagnosis of AD at a later stage in an Australian population.
Methods: Cross-sectional analysis of baseline clinical data of participants in the Australian Dementia Network (ADNeT) Registry with newly diagnosed AD between 2020-2023. Later-stage diagnosis was defined by a Mini-Mental State Examination score <22/30, or, if unavailable, scores on the Rowland Universal Dementia Assessment Scale (<22/30) or Montreal Cognitive Assessment (<16/30). Multivariable logistic regression was used to identify demographic, clinical, and health service factors associated with later-stage diagnosis.
Results: Of 2,287 participants, 47.4% were diagnosed at a later stage. Lower educational attainment (OR = 5.33, 95% CI 3.83-7.43), Non-English-speaking status (OR = 2.67, 95% CI = 1.93-3.70), living with others (OR = 1.48, 95% CI = 1.19-1.82) and mixed dementia pathology (OR = 1.64, 95% CI = 1.37-1.96) were all significantly associated with a diagnosis at a later-stage in adjusted multivariate models.
Conclusion: Almost half of individuals newly diagnosed with AD in Australian memory clinics contributing to the ADNeT Registry, receive their diagnosis at a later stage. Recognition of the characteristics associated with this, as identified in this study, can help inform interventions to enable more timely diagnosis and access to post-diagnostic care and treatment in these at risk-populations.