The impact of active community-based survey on dementia detection ratio in Taiwan: A cohort study with historical control

Yun-Ru Lu; Tzy-Haw Wu; Yachung Jeng; Wen-Yuan Lee; Wei-Chih Hsu; Amy Ming-Fang Yen; Shin-Liang Pan; Yen-Ching Chen; Sam Li-Sheng Chen; Hsiu-Hsi Chen; Horng-Huei Liou

doi:10.3389/fpubh.2022.1005252

The impact of active community-based survey on dementia detection ratio in Taiwan: A cohort study with historical control

Front Public Health. 2023 Jan 6:10:1005252. doi: 10.3389/fpubh.2022.1005252. eCollection 2022.

Authors

Affiliations

¹ Department of Neurology, China Medical University Hospital, Taipei, Taiwan.
² Department of Internal Medicine, National Taiwan University, Taipei, Taiwan.
³ School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.
⁴ Department of Neurosurgey, China Medical University Hospital, Taichung, Taiwan.
⁵ Department of Neurology, Shin Kong Memorial Wu Ho-Su Hospital, Taipei, Taiwan.
⁶ Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan.
⁷ Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
⁸ Department of Neurology and Pharmacology, College of Medicine, National Taiwan University Hospital, Yunlin, Taiwan.

Abstract

Background: Although early dementia detection is crucial to optimize the treatment outcomes and the management of associated symptoms, the published literature is scarce regarding the effectiveness of active screening protocols in enhancing dementia awareness and increasing the rate of early detection. The present study compared the detection ratio of an active community-based survey for dementia detection with the detection ratio of passive screening during routine clinical practice. Data for passive screening were obtained from the National Health Insurance (NHI) system, which was prospectively collected during the period from 2000 to 2003.

Design: A population-based cohort study with historical control.

Setting: Taiwan.

Participants: A total of 183 participants aged 65 years or older were involved in a community-based survey. Data from 1,921,308 subjects aged 65 years or older were retrieved from the NHI system.

Measurements: An adjusted detection ratio, defined as a ratio of dementia prevalence to incidence was used.

Results: The results showed that the dementia prevalence during the 2000-2003 period was 2.91% in the elderly population, compared with a prevalence of 6.59% when the active survey was conducted. The incidence of dementia in the active survey cohort was 1.83%. Overall, the dementia detection ratio was higher using active surveys [4.23, 95% confidence interval (CI): 2.68-6.69] than using passive detection (1.45, 95% CI: 1.43-1.47) for those aged 65-79 years. Similar findings were observed for those aged 80 years and older.

Conclusion: The implementation of an active community-based survey led to a 3-fold increase in the detection rate of early dementia detection compared to passive screening during routine practice.

Keywords: awareness; dementia; early detection; incidence; prevalence.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Cohort Studies
Dementia* / diagnosis
Dementia* / epidemiology
Humans
Incidence
Surveys and Questionnaires
Taiwan / epidemiology

Grants and funding

This study was supported by the China Medical University Hospital, Taiwan (CMU No. DMR-103-051) and the Ministry of Science and Technology (MOST 107-3017-F-002-003) and Featured Areas Research Center Program within the framework of the Higher Education Sprout Project by the Ministry of Education (MOE) in Taiwan (grant number 111-2314B-002-251).