{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T23:09:32Z","timestamp":1794265772106,"version":"4.9.0"},"reference-count":28,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T00:00:00Z","timestamp":1777075200000},"content-version":"vor","delay-in-days":24,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Geriat Psychiatry"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To estimate the national proportion of undiagnosed dementia cases in Brazil, examine its distribution across Brazilian regions sociodemographic subgroups, and identify factors associated with receiving a diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a cross\u2010sectional, population\u2010based analysis using baseline data (2015\u20132016) from the Brazilian Longitudinal Study of Aging (ELSI\u2010Brazil), a nationally representative survey of community\u2010dwelling adults. Dementia was identified through an established algorithm incorporating cognitive testing and functional impairment, combined with self\u2010reported medical diagnosis of Alzheimer's disease. Underdiagnosis was defined as meeting dementia criteria without a prior medical diagnosis. Sociodemographic, clinical, cognitive, and functional variables were assessed. Survey\u2010weighted logistic regression models estimated factors associated with underdiagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 5249 participants aged \u2265\u00a060\u00a0years, 392 met criteria for dementia. Overall, 83.1% (95% CI: 76.5\u201388.1) had no previous diagnosis. Underdiagnosis was more frequent in poorer regions (90.2%) than in richer regions (76.0%), and higher among illiterate individuals (93.9%). In fully adjusted models, older age (OR\u00a0=\u00a00.91; 95% CI: 0.85\u20130.97), more years of education (OR\u00a0=\u00a00.86; 95% CI: 0.76\u20130.96), a higher number of chronic conditions (OR\u00a0=\u00a00.72; 95% CI: 0.54\u20130.97), and better memory performance (OR\u00a0=\u00a00.68; 95% CI: 0.56\u20130.84) were associated with a lower likelihood of underdiagnosis, while living alone was associated with a higher likelihood of underdiagnosis (OR = 3.65 [1.05\u201312.6]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>About four in five older Brazilians meeting dementia criteria had no prior clinical diagnosis, with marked sociodemographic and regional disparities. Both individual factors\u2014such as age, education, and multimorbidity\u2014and structural inequities across regions influenced diagnostic likelihood. Strengthening early\u2010detection strategies, improved health professional training, and regionally tailored approaches may improve recognition of dementia in Brazil's public health system.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/gps.70219","type":"journal-article","created":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T18:19:41Z","timestamp":1777141181000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Inequities in Dementia Diagnosis: Evidence From the ELSI\u2010Brazil Study"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-3404-2168","authenticated-orcid":false,"given":"Andrew Christopher Claro","family":"Miguel","sequence":"first","affiliation":[{"name":"Department of Psychiatry Escola Paulista de Medicina Universidade Federal de Sao Paulo  Sao Paulo 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Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Fernanda","family":"Lima\u2010Costa","sequence":"additional","affiliation":[{"name":"Center of Studies in Public Health and Aging Funda\u00e7\u00e3o Oswaldo Cruz e Universidade Federal de Minas Gerais  Belo Horizonte Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matheus Ghossain","family":"Barbosa","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Escola Paulista de Medicina Universidade Federal de Sao Paulo  Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1815-7685","authenticated-orcid":false,"given":"Cleusa Pinheiro","family":"Ferri","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Escola Paulista de Medicina Universidade Federal de Sao Paulo  Sao Paulo Brazil"},{"name":"Research Unit Responsabilidade Social \u2010 Hospital Alem\u00e3o Oswaldo Cruz  S\u00e3o Paulo 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