Attitudes and preferences towards screening for dementia: a systematic review of the literature

BMC Geriatrics

Research Article

Sarah Cullum¹  Ayesha Khan²  Steven Martin²  Louise Lafortune²  Sarah Kelly²  Carol Brayne²  Theodore Cosco²  Cornelius Katona³  Chris Fox⁴  Tom Dening⁵  Greta Rait⁶ 

[1] Academic Unit of Psychiatry, University of Bristol, Bristol, UK;Cambridge Institute of Public Health, University of Cambridge, Cambridge, UK;Division of Psychiatry, University College London, London, UK;Faculty of Medicine and Health Sciences, Norwich, UK Medical School, University of East Anglia, Norwich, UK;Institute of Mental Health, University of Nottingham, Nottingham, UK;Research Department of Primary Care and Population Health, UCL Medical School, UCL, London, UK;

关键词: Patient and public involvement;    Screening;    Dementia;    Attitudes;    Preferences;    Oldest-old;   

DOI  :  10.1186/s12877-015-0064-6

 received in 2014-09-25, accepted in 2015-05-26,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundPopulation screening might provide a mechanism to enable early detection of dementia. Yet the potential benefits, harms or acceptability of such a large-scale intervention are not well understood. This research aims to examine the attitudes and preferences of the general public, health care professionals, people with dementia and their carers towards population screening for dementia.MethodsA systematic review of the international literature was undertaken. A search of fifteen bibliographic databases was conducted (up to 12 July 2012; no language restriction) using terms related to dementia, screening, specific screening tools, case finding, and attitudes and preferences; genetic screening and biomarkers were excluded. All study designs were included except opinion-based papers. Included papers were doubly quality assessed and thematically analysed using NVivo.Results29,910 papers were identified of which 29 met the inclusion criteria. We identified seventeen themes relating to the 3 phases of the screening process (pre-, in- and post-screen) – none emerged as more of a facilitator than a barrier to the acceptance of dementia screening. Seven themes emerged in relation to the patient, carer and general population: existing health state; lifestyle and life view; awareness of dementia; role of clinician; communication; benefit; and role of the family. Ten themes emerged in relation to the clinician and healthcare professional: patient’s existing health and comorbidities; awareness of dementia; confidence; duration of patient contact; suitability of screening tool; cost; disclosure; time; treatment and prognosis; and stigma.ConclusionsAs for all screening programmes, screening for dementia raises complex issues around preference and choice for clinicians and the public, and it is unclear what specific factors promote or reduce screening acceptance the most. Overall, the level of evidence is low, few large scale studies have been undertaken and none were conducted in representative samples, all affecting the generalizability of identified themes across healthcare contexts. Nevertheless, our findings suggest that population screening for dementia may not be acceptable to either the general public or health care professionals, and highlight where focused efforts are needed to gain insights into dementia specific issues.

【 授权许可】

CC BY   
© Martin et al. 2015