Tertiary center referral delay of patients with dementia in Southern Brazil: associated factors and potential solutions

ABSTRACT. Early dementia diagnosis has many benefits and is a priority. In Brazil, most cases are diagnosed by a specialist. Objective: We aimed to study the average time from disease onset to specialist assessment and related factors; we also propose potential strategies to deal with this delay. Methods: This was a cross-sectional database study in 245 patients with dementia from an outpatient clinic in a tertiary university hospital in Southern Brazil, which only assesses individuals from the Unified Health System (SUS). The outcome was time from symptoms onset to specialist assessment, reported by the informants. Individuals were separated into two groups: less and more than 1 year to specialist assessment. Multivariable analysis was used to test the potential related factors associated with delayed specialist assessment. Results: Mean±SD of time from symptoms onset to specialist assessment was 3.3±3.3 years. In the unadjusted analysis, individuals who were assessed before 1 year were more often diagnosed with vascular dementia, had more sudden and subacute onset, neuropsychiatric symptoms at presentation, rapid progression, and alcohol and antipsychotics use (p