Determinants of time from symptom debut to dementia diagnosis in United Arab Emirates

Background Although timely dementia diagnosis is a global healthcare priority, delays between symptom onset and formal recognition remain common, particularly in regions with limited awareness and high stigma. Such delays are associated with worse clinical outcomes, greater caregiver burden and increased healthcare costs. We report the first large-scale study of diagnostic delays in the United Arab Emirates (UAE) and the wider Middle East and North Africa, with findings relevant to other Gulf Cooperation Council countries, given the region’s unique demographic and cultural landscape. Aims To investigate the duration between dementia symptom onset and formal diagnosis, and to identify demographic and clinical factors associated with prolonged delays. Method We retrospectively analysed 825 patients diagnosed with dementia over 10 years at a major governmental hospital in Abu Dhabi. The duration of undiagnosed symptoms (DUS) was calculated and multivariable regression was performed, adjusting for age, gender, nationality, dementia subtype and presenting symptoms. Results The mean DUS was 34.7 months (s.d. = 28.8), with a median of 24 months (interquartile range 12–48 months). Older adults (≥65 years) experienced longer delays than younger patients. Symptom profile strongly influenced DUS: patients presenting with memory complaints (forgetfulness) had the longest delays, whereas those with behavioural or psychiatric symptoms, such as agitation, hallucinations or disinhibition, were diagnosed earlier. In multivariable regression, older age and memory-related presentations remained independent predictors of longer DUS while gender, nationality and dementia subtype were not significant. Conclusions Dementia diagnosis in the UAE is delayed by nearly 3 years, driven mainly by age and presenting symptoms. Reducing these delays through public awareness campaigns, clinician training and pilot primary care screening programmes could improve patient outcomes and reduce the growing health economic burden in the region.