Why people hesitate about dementia screening: A systematic review and meta-analysis

Objectives: Dementia, a global leading cause of death, increasingly impacts populations, highlighting the critical need for early diagnosis to effectively manage neurodegenerative conditions. Despite the clear benefits of early intervention, widespread hesitancy to undergo screening contributes to a significant prevalence of undiagnosed dementia worldwide. This study explores the factors contributing to this hesitancy towards dementia screening. Methods: This systematic review and meta-analysis followed PRISMA guidelines, utilizing a detailed search strategy across five databases. The data synthesis combined qualitative thematic analysis with a random-effects meta-analysis approach. Findings: Analyzing 34 articles, this review focused on the attitudes towards dementia screening among middle-aged and older adults aged 40 and above, finding a 62.6 % acceptance rate. We identified eight main factors that influence the willingness to undergo dementia screening. The results of meta-analysis suggested that increased knowledge about dementia, perceived screening benefits, and heightened perceived susceptibility significantly boost screening intentions. Discussion: Dementia screening hesitancy continues to be a significant issue. While several facilitators and barriers to screening have emerged, their effectiveness varies across healthcare contexts. The complex interplay among these diverse factors influencing screening acceptance suggests the need for balanced, context-sensitive approaches in future research.