Table 1 Challenges of diagnosing dementia in the oldest old
From: Dementia in the oldest old: a multi-factorial and growing public health issue
Challenges | Repercussions |
|---|---|
Medical illness, sensory loss (vision/hearing), and physical impairments increasingly contribute to functional decline | Functional impairment is overestimated, leading to overdiagnosis of dementia |
Retirement and restricted household responsibilities lead to reduced cognitive demands | Functional impairment is underestimated, leading to underdiagnosis of dementia |
Cognitive decline may be considered part of normal aging | Functional impairment is underestimated, leading to underdiagnosis of dementia |
Increased likelihood of cognitive impairment in collateral informants of the oldest old compared with the younger old | Functional impairment is underestimated, leading to underdiagnosis of dementia |
Lack of normative neuropsychological data | Objective cognitive impairments are overestimated or underestimated, leading to misdiagnosis |
Limitations of standard diagnostic criteria | More sensitive for some dementia subtypes, less sensitive for other types |