BACKGROUND An estimated 50 million people worldwide have Alzheimer's disease and related dementias (ADRD), and this number is projected to increase with the growth of the aging population, with the largest growth occurring in low and middle-income countries. Diagnostic coverage for dementia is estimated to be only 5-10% in low- and middle-income countries. Timely diagnosis of ADRD could prompt early access to information, medical treatments, and support for caregivers. The aim of this study was to assess how healthcare workers in rural southwestern Uganda assess for and diagnose ADRD. METHODS We used in-depth interviews to investigate the medical knowledge and clinical practices surrounding ADRD diagnoses among 42 healthcare workers employed at mid-tier health facilities in southwestern Uganda. Qualitative content analysis was used to identify distinct categories and themes. RESULTS Our findings show that healthcare workers without specific mental health training assessed and diagnosed dementia based on history and physical examination alone. On the other hand, healthcare workers with some specialized training in mental health were more likely to use neuropsychological tests, blood tests, urine tests, and brain imaging in the diagnosis of dementia. Collateral history from caregivers was noted to be very important in proper assessment and diagnosis of dementia among all categories of healthcare workers. The majority of healthcare workers regarded memory loss as part of the normal aging process and reported that it does not need any specific treatment. Other healthcare workers could recognize signs and symptoms of dementia, but focused on managing other medical problems at the expense of assessing cognitive decline and mental health. Diagnostic practices did not differ based on age, years of experience, or gender of the healthcare workers. CONCLUSION These results indicate that specialized training in mental health among healthcare workers is crucial for the assessment and diagnosis of ADRD in rural southwestern Uganda.

中文翻译：

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乌干达西南部农村医护人员的痴呆症评估和诊断实践：一项横断面定性研究。

背景估计全世界有5000万人患有阿尔茨海默病和相关痴呆症(ADRD)，预计这一数字将随着人口老龄化的增长而增加，其中低收入和中等收入国家的增长最大。在低收入和中等收入国家，痴呆症的诊断覆盖率估计只有 5-10%。ADRD 的及时诊断可以促使及早获得信息、医疗和对护理人员的支持。本研究的目的是评估乌干达西南部农村的医护人员如何评估和诊断 ADRD。方法我们使用深度访谈来调查在乌干达西南部中级卫生机构工作的 42 名医护人员围绕 ADRD 诊断的医学知识和临床实践。定性内容分析用于识别不同的类别和主题。结果 我们的研究结果表明，未经特定心理健康培训的医护人员仅根据病史和体格检查来评估和诊断痴呆症。另一方面，在心理健康方面接受过一些专门培训的医护人员更有可能使用神经心理测试、血液测试、尿液测试和脑成像来诊断痴呆症。护理人员的附带病史被指出对于所有类别的医疗保健工作者的痴呆症的正确评估和诊断非常重要。大多数医护人员将记忆丧失视为正常衰老过程的一部分，并报告说不需要任何特殊治疗。其他医护人员可以识别痴呆症的迹象和症状，但专注于管理其他医疗问题，而忽视了评估认知能力下降和心理健康。诊断实践不会因医护人员的年龄、经验年限或性别而异。结论 这些结果表明，医护人员的心理健康专业培训对于乌干达西南部农村地区 ADRD 的评估和诊断至关重要。