Diagnosis of dementia in residential aged care settings in Australia: an opportunity for improvements in quality of care?

Objective: To examine the cognitive status of Australians living in residential aged care facilities (RACFs) and whether or not a dementia diagnosis was recorded. 

Methods: Cross-sectional study of 541 residents of 17 RACFs spanning four states. Examination of cognitive status by Psychogeriatric Assessment Scale Cognitive Impairment Scale (PAS-Cog) and dementia diagnosis from medical records. 

Results: The study population included 65% of residents with a diagnosis of dementia recorded, and 83% had a PAS-Cog score of four or more indicating likely cognitive impairment. More than 20% of participants had likely cognitive impairment (PAS-Cog ≥4), but no diagnosis of dementia; 11% had moderate-to-severe cognitive impairment (PAS-Cog ≥10) but no recorded dementia diagnosis. 

Conclusion: There may be a lack of formal diagnosis of dementia in Australian RACFs. Greater efforts from all health professionals to improve diagnosis in this setting are required. This is an opportunity for improved person-centred care and quality of care in this vulnerable population.