Timely diagnosis of dementia: the contribution of non-medical and informal contacts

Objectives: This study explores what prompts individuals working in non-medical occupations with frequent contact with older adults to suspect cognitive problems and take action. 

Method: A survey was developed through consultation and pre-testing. Dutch-speaking adults were recruited from occupation groups that regularly engage with older people. Quantitative data were analyzed descriptively. Qualitative data were analyzed using manifest content analysis and directed content analysis guided by the I-Change model. 

Results: Of 156 participants, most worked in household care, hairdressing, municipalities, or libraries. In professional settings, 103/130 participants (79%) reported having suspected dementia in at least one client or colleague, of whom 59/103 (57%) took action. In community settings, 35/128 participants (27%) had suspicions, with 16/35 (46%) acting. Actions included mentioning their concerns with the person and/or family or informing a healthcare professional or their supervisor at work. Awareness was influenced by ‘knowledge’, ‘risk perception’, and ‘perceived cues’. Factors influencing motivation to act were ‘attitude’ (e.g. feeling responsible or valuing offering help), ‘social support’ (e.g. encouragement from employers), and ‘self-efficacy’. Determinants for action were ‘skills’ and ‘barriers’. 

Conclusion: People who suspect dementia in someone they know often feel a responsibility to act. Broader samples are needed for future research to improve generalizability.