World Alzheimer Report 2021

Journey through the diagnosis of dementia

The World Alzheimer Report 2021 includes over 50 essays from leading experts from around the world and is supported by findings from 3 key global surveys, which received responses from 1,111 clinicians, 2,325 people with dementia and carers, and over 100 national Alzheimer and dementia associations.

This report focuses on the crucial and timely subject of diagnosis. Diagnosis is still a major challenge globally, with those who seek a diagnosis often experiencing long wait times, if they are able to receive a diagnosis at all. Societal stigma, self-stigma and clinician related stigma also exacerbate what is already a difficult journey.

With this report, we explore this diagnosis journey through the lens of those living with dementia and carers, clinicians, researchers and academics, and Alzheimer and dementia associations, as well as what can and must be improved.

In the report foreword, ADI CEO Paola Barbarino writes:

Dementia is now the 7th leading cause of mortality globally and, as we know from previous World Alzheimer Reports, one of those with the highest cost to society. There is a perfect storm gathering on the horizon and governments all over the world should get to grips with it.

World Alzheimer Report 2021: Chapter overviews

Chapter 1:  What is dementia, why make a diagnosis and what are the current roadblocks?

46% of people living with dementia and carers identified fear of diagnosis and stigma as barriers to diagnosis.

Read chapter 1 

Chapter 2: Who makes the diagnosis of dementia and how do you prepare for the assessment?
Read chapter 2 
Chapter 3: Medical history and physical examination
Read chapter 3
Chapter 4: Functional assessment
Read chapter 4
Chapter 5: Mood and behavioural assessment
Read chapter 5

55% of people said they were given inadequate information at diagnosis, a major gap in signposting from clinicians.

Chapter 6: Cognitive assessments
Read chapter 6
Chapter 7: Preliminary diagnosis of cognitive decline
Read chapter 7
Chapter 8: General laboratory tests
Read chapter 8 
Chapter 9: Brain imaging using CT and MRI
Read chapter 9 
Chapter 10: Brain imaging using PET and SPECT
Read chapter 10
Chapter 11: Spinal fluid

62% of healthcare practioners still believe that dementia is a normal part of ageing.

Read chapter 11
Chapter 12: Genetic testing
Read chapter 12 
Chapter 13: Diagnostic tests: novel biomarkers
Read chapter 13
Chapter 14: Differential diagnosis
Read chapter 14
Chapter 15: Disclosure of results
Read chapter 15
Chapter 16: Initial management following a diagnosis of dementia
Read chapter 16

90% of clinicians identified additional delays or wait times due to COVID-19.

Chapter 17: Re-evaluation of diagnosis over time
Read chapter 17
Chapter 18: Limited access to healthcare resources
Read chapter 18
Chapter 19: Low education
Read chapter 19
Chapter 20: Sex, gender and cultural factors
Read chapter 20
Chapter 21: Impact of a world pandemic on the diagnosis of dementia
Read chapter 21

35% of carers globally have hidden the diagnosis of a person with dementia.

Chapter 22: Multiple comorbidities
Read chapter 22
Chapter 23: Young-onset dementias
Read chapter 23
Chapter 24: Costs factors in diagnosing dementia
Read chapter 24
Chapter 25: New challenges and opportunities in the diagnosis of dementia
Read chapter 25

About the authors

This report has been overseen by the McGill University Research Centre in Studies in Aging and the McGill Faculty of Medicine and Health Sciences, specifically the Division of Geriatric Medicine and the Dementia Education Program, supported by the Office of Education Technology and Online Learning at the Steinberg Centre for Simulation and Interactive Learning. Together, they are leading complementary initiatives devoted to prevention, diagnostics, management, education, knowledge dissemination and support for care partners.

Learn more about the team

World Alzheimer Report 2021 report launch

Watch a recording of the report launch event for the World Alzheimer Report 2021, which includes a global panel of experts discussing the key findings and recommendations of the report and more.

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