title: Delayed help seeking behavior in dementia care: preliminary findings from the Clinical Pathway for Alzheimer's Disease in China (CPAD) study.
abstract: BACKGROUND
  The prevalence and factors associated with delays in help seeking for people with dementia in China are unknown.
  
  
  METHODS
  Within 1,010 consecutively registered participants in the Clinical Pathway for Alzheimer's Disease in China (CPAD) study (NCT01779310), 576 persons with dementia (PWDs) and their informants reported the estimated time from symptom onset to first medical visit seeking diagnosis. Univariate analysis of general linear model was used to examine the potential factors associated with the delayed diagnosis seeking.
  
  
  RESULTS
  The median duration from the first noticeable symptom to the first visit seeking diagnosis or treatment was 1.77 years. Individuals with a positive family history of dementia had longer duration (p = 0.05). Compared with other types of dementia, people with vascular dementia (VaD) were referred for diagnosis earliest, and the sequence for such delays was: VaD < Alzheimer's disease (AD) < frontotemporal dementia (FTD) (p < 0.001). Subtypes of dementia (p < 0.001), family history (p = 0.01), and education level (p = 0.03) were associated with the increased delay in help seeking.
  
  
  CONCLUSIONS
  In China, seeking diagnosis for PWDs is delayed for approximately 2 years, even in well-established memory clinics. Clinical features, family history, and less education may impede help seeking in dementia care.
authors.affiliation: Dementia Care & Research Center,Peking University Institute of Mental Health (Sixth Hospital);Beijing Municipal Key Laboratory for Translational Research on Diagnosis and Treatment of Dementia,Beijing 100191,China.
authors.forename: Mei
authors.initials: M
authors.lastname: Zhao
authors.affiliation: Dementia Care & Research Center,Peking University Institute of Mental Health (Sixth Hospital);Beijing Municipal Key Laboratory for Translational Research on Diagnosis and Treatment of Dementia,Beijing 100191,China.
authors.forename: Xiaozhen
authors.initials: X
authors.lastname: Lv
authors.affiliation: Dementia Care & Research Center,Peking University Institute of Mental Health (Sixth Hospital);Beijing Municipal Key Laboratory for Translational Research on Diagnosis and Treatment of Dementia,Beijing 100191,China.
authors.forename: Maimaitirexiati
authors.initials: M
authors.lastname: Tuerxun
authors.affiliation: Department of Neurology,The First Affiliated Hospital,Wenzhou Medical College,Wenzhou 325000,Zhejiang Province,China.
authors.forename: Jincai
authors.initials: J
authors.lastname: He
authors.affiliation: Department of Neurology,The First Affiliated Hospital of Zhejiang University,Hangzhou 310003,Zhejiang Province,China.
authors.forename: Benyan
authors.initials: B
authors.lastname: Luo
authors.affiliation: Department of Psychiatry,Sir Run Run Shaw Hospital,School of Medicine,Zhejiang University,Hangzhou 310016,Zhejiang Province,China.
authors.forename: Wei
authors.initials: W
authors.lastname: Chen
authors.affiliation: Department of Neurology,The First Affiliated Hospital of Anhui Medical University,Hefei 230022,Anhui Province,China.
authors.forename: Kai
authors.initials: K
authors.lastname: Wang
authors.affiliation: Department of Neurology,The First Hospital of Hebei Medical University,Shijiazhuang 050031,Hebei Province,China.
authors.forename: Ping
authors.initials: P
authors.lastname: Gu
authors.affiliation: Mental Health Center,West China Hospital,Sichuan University,Chengdu 610041,Sichuan Province,China.
authors.forename: Weihong
authors.initials: W
authors.lastname: Kuang
authors.affiliation: Department of Neurology,Tianjin Huanhu Hospital,Tianjin 300060,China.
authors.forename: Yuying
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: Department of Neurology,First Affiliated Hospital of Medical College of Xi'an Jiaotong University,Xi'an 710061,Shanxi Province,China.
authors.forename: Qiumin
authors.initials: Q
authors.lastname: Qu
authors.affiliation: Department of Psychological Medicine,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China.
authors.forename: Jianhua
authors.initials: J
authors.lastname: He
authors.affiliation: Department of Neurology,General Hospital,Tianjin Medical University,Tianjin 300052,China.
authors.forename: Nan
authors.initials: N
authors.lastname: Zhang
authors.affiliation: Department of Geriatric Psychiatry,Shandong Mental Health Center,Jinan 250014,Shandong Province,China.
authors.forename: Yongping
authors.initials: Y
authors.lastname: Feng
authors.affiliation: Department of Neurology,The Second Affiliated Hospital of Guangzhou Medical University,Guangzhou 510260,Guangdong Province,China.
authors.forename: Yanping
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Dementia Care & Research Center,Peking University Institute of Mental Health (Sixth Hospital);Beijing Municipal Key Laboratory for Translational Research on Diagnosis and Treatment of Dementia,Beijing 100191,China.
authors.forename: Xin
authors.initials: X
authors.lastname: Yu
authors.affiliation: Dementia Care & Research Center,Peking University Institute of Mental Health (Sixth Hospital);Beijing Municipal Key Laboratory for Translational Research on Diagnosis and Treatment of Dementia,Beijing 100191,China.
authors.forename: Huali
authors.initials: H
authors.lastname: Wang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis* / Q000208:ethnology / Q000628:therapy; D044466:Asian People / Q000523:psychology*; D002681:China; D019091:Critical Pathways; D057210:Delayed Diagnosis; D003704:Dementia / Q000145:classification / Q000175:diagnosis / Q000628:therapy; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data; D000066505:Help-Seeking Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D013997:Time Factors
keywords: dementia; duration of delay; help-seeking behavior