How often are patients with Alzheimer disease given that diagnosis?

Background Alzheimer Disease (AD) is the most common cause for dementia, but outside the research setting the majority of people who meet diagnostic criteria for AD do not receive the diagnosis of AD, or in some cases do not even receive a diagnosis of dementia. Much of the data on this subject come from research studies, however, and relatively less is drawn from community practice. The author began a Memory Clinic within a large health system in the city of Charlotte, NC, in February 2019. All referrals for cognitive complaints within that system, came to the author's clinic. This affords a "real world" environment to assess the diagnoses assigned by clinicians, to patients who meet diagnostic criteria for AD. Method All new patient evaluations for a one‐year period were examined. For those patients determined to meet diagnostic criteria for "probable" AD, the specialty of the referring clinician, and the diagnosis assigned by the referring clinician, was assessed. Severity of dementia was estimated using the Mini‐Mental State Exam (MMSE), as Mild (≥20), Moderate (10‐19), or Severe (≤9). Result Of the patients diagnosed with "probable" AD during the first year of clinic, 9% had previously received no cognitive diagnosis, 48% had been given a diagnosis simply of "memory loss," 12% had been given a nonspecific diagnosis of "dementia," a few some other diagnosis, and 25% had been given the diagnosis of AD. These percentages didn't vary a lot between levels of severity, except to note there were few "severe" patients, and interestingly, the majority of patients who carried no cognitive diagnosis at all, had "moderate" dementia. Conclusion These data provide further evidence that most people who meet diagnostic criteria for Alzheimer Disease, do not receive a specific etiologic diagnosis for their dementia.