A mapping review of studies exploring the barriers and facilitators to a dementia diagnosis through an intersectionality lens

TL;DR

This paper reviews studies on dementia diagnosis barriers and facilitators, highlighting gaps in understanding how social factors influence the process.

Contribution

The study provides a mapping review using an intersectional lens to identify gaps in dementia diagnosis research.

Findings

Most studies focus on high-income countries and lack specific social categorization.

Ethnicity is one of the few social categories with substantial research attention.

Socioeconomic status, gender, and sexual orientation are under-researched in dementia diagnosis studies.

Abstract

Promoting a ‘timely’ diagnosis is a global policy directive.

This review adopts an intersectional approach, visually mapping the existing literature to highlight gaps in the evidence base on barriers and facilitators to dementia diagnosis.

A systematic approach was undertaken, following the PRISMA guidelines, updating previous reviews. The literature search was conducted on PubMed, PsycINFO, CINAHL Complete and Scopus. In line with mapping review methodology, we report the current state of the literature by describing the number of studies that outline barriers and facilitators to seeking help for a dementia diagnosis, split by social categorisation.

On the 7 June 2024, a total of 45 studies were identified. Our mapping demonstrated the majority of studies were derived from high-income countries and did not specify whether they were exploring barriers and facilitators through a specific social lens. Ethnicity was one of the few social categories where a range of evidence was reported. Other categories, such as socioeconomic status, gender and sexual orientation, received limited research attention.

Our mapping review suggests the large body of work within this field tends to treat people with dementia and their carers as homogenous and androgenous groups. To better inform this key policy directive, studies are needed that explore the influence of social determinants on people’s experiences of seeking a dementia diagnosis. Such work would create a richer, more nuanced evidence base that better elicits ways of addressing inequalities and inequities that arise at this key stage of people’s dementia care journey.

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