Scoping Review Finds Gaps in Person-Centred Dementia Diagnosis

A scoping review of 23 publications found that person-centred care is most strongly represented in the clinical assessment and disclosure stages of dementia diagnosis, while detection, screening, post-diagnostic support and emerging diagnostic technologies receive less attention. The analysis also showed that research commonly emphasizes exchanging information and fostering relationships, with comparatively limited consideration of managing uncertainty, shared decision-making and enabling self-management. The review maps how person-centredness has been defined and applied across the diagnostic journey; it does not test whether a particular approach improves clinical outcomes.

The authors searched six databases for peer-reviewed literature published between 1990 and 2025. Publications were eligible if they conceptualized dementia diagnosis using an established person-centred care framework or clearly articulated a definition of person-centredness. The included evidence covered conceptual and perspective papers as well as qualitative, quantitative and mixed-methods studies.

Reviewers extracted information about study characteristics, conceptual approaches, person-centred practices, barriers and enablers, then mapped the findings to the Person-Centred Care and Support framework. Members of two working groups that included people with dementia and informal carers discussed the findings, bringing lived experience into the interpretation of the evidence. The 23 publications were divided in how they described person-centredness: 52.2% cited established, theory-driven frameworks, whereas 47.8% characterized it mainly through practical clinical terms.

The distribution of research also varied by stage of the diagnostic journey. Assessment was addressed in 73.9% of studies and disclosure in 60.9%, compared with 43.5% for detection and screening and 34.8% for post-diagnostic support. These percentages describe the focus of the included publications rather than the proportion of diagnoses in clinical services that meet person-centred standards.

The scoping design identifies where published attention is concentrated and where evidence is limited, but it cannot establish how consistently person-centred practices are implemented in real-world care. Mapping the practices against the Person-Centred Care and Support framework revealed that relational domains were prioritized over other elements of care. Exchanging information and fostering relationships received more attention than managing uncertainty, shared decision-making and enabling self-management.

Reported barriers existed at three levels. Person-level barriers included stigma, healthcare-worker barriers included time pressure, and system-level barriers included fragmented diagnostic pathways. Its function was to map the available literature and provide preliminary guidance rather than demonstrate the effectiveness of an intervention or care model.

The analysis also identified two areas with sparse representation. Few studies incorporated lived experience when developing recommendations, and few addressed emerging diagnostic technologies such as blood-based biomarkers or artificial-intelligence-driven assessments. Instead, their limited coverage shows that the research literature has not yet fully examined the relationship between new diagnostic methods and the principles represented in the review.

The authors propose unified frameworks extending across the full diagnostic journey, co-production of diagnostic models and pathways with people with dementia and their informal carers, and the use of person-centred standards to guide the integration of emerging technologies. These proposals are conclusions drawn from the evidence map, not tested effects. Overall, the review indicates that operationalizing person-centred principles throughout detection, assessment, disclosure and post-diagnostic support remains a substantial task for individuals, informal carers, clinicians and health systems, particularly given the limited and heterogeneous evidence base.

Subject of Research: A scoping review of how person-centred care is conceptualized and applied throughout the dementia diagnostic journey.

Article Title: Person-centredness in dementia diagnosis & detection: a scoping review

Article References: Guo, M. Y., Diaz, A., Gove, D., Jessen, F., Khoury, C. P., Wiley, R. E., & El-Hayek, Y. H. (2026). Person-centredness in dementia diagnosis & detection: a scoping review. BMC Health Services Research. https://doi.org/10.1186/s12913-026-15544-5

Image Credits: AI Generated

DOI: 10.1186/s12913-026-15544-5

Keywords: dementia diagnosis, person-centred care, scoping review, Alzheimer’s disease, dementia assessment, diagnosis disclosure, shared decision-making, post-diagnostic support, blood biomarkers, artificial intelligence, Person-centredness, dementia