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2023 Alzheimer's Association Research Fellowship to Promote Diversity (AARF-D)

Undiagnosed Dementia in Hospitals: Prevalence, Risk Factors, and Outcomes

How does undiagnosed dementia impact the health of individuals undergoing hospitalization?

Márlon Aliberti, M.D., Ph.D.
University of Sao Paulo Medical School
Sao Paulo, Brazil


Studies report that nearly two-thirds of individuals with Alzheimer’s and other dementias live in low and middle income countries. These countries may also have higher numbers of adults with undiagnosed dementia, especially among individuals from vulnerable racial and ethnic groups. Undiagnosed dementia can present challenges for hospitals worldwide – challenges that may lead to below-optimal care and a higher risk of adverse (negative) health outcomes (including death) for individuals with dementia. Thus, there is a need to understand the prevalence of undiagnosed dementia in low and middle income countries, and to clarify how individuals with undiagnosed dementia are at risk in those countries’ hospitals.    

Research Plan

Dr. Márlon Aliberti and colleagues will study undiagnosed dementia in 1,200 diverse individuals in a Brazil-based study called Creating a Hospital Assessment Network in Geriatrics (CHANGE) using cognitive, medical and socioeconomic data. First, the researchers will study how the individuals performed on cognitive tests and on questionnaires designed to identify memory complaints. These analyses will identify the prevalence of dementia among the individuals, and how that prevalence may differ among individuals of different racial or socioeconomic backgrounds, sexes, countries and rural or urban regions. Next, Dr. Aliberti and colleagues will use CHANGE data to study how various risk factors for cognitive loss (such as smoking, low physical activity and high blood pressure) may be linked to undiagnosed dementia in hospitals. Third, the team will examine how individuals with undiagnosed dementia and mild cognitive impairment (MCI: a condition of subtle memory loss that may precede dementia) are at risk for negative health outcomes, including death, after hospitalization. They will also compare how these risks vary among individuals with undiagnosed dementia, individuals with diagnosed dementia and individuals without dementia.    


The results of this project could shed new light on the impact of undiagnosed dementia in lower income countries. They could also lead to strategies for improving dementia diagnosis and care – as well as reducing dementia-related health emergencies – in hospital settings worldwide. 

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