Sociodemographic and clinical determinants of the dementia treatment gap in Singapore and their evolution over a decade

In Singapore, despite significant public health and clinical initiatives, challenges persist in dementia diagnosis. Building on prior evidence of a reduction in the dementia treatment gap, this study examined the sociodemographic and clinical determinants of the treatment gap and how their associations evolved over a decade. This study utilised data from two nationally representative, cross-sectional surveys (Well-being of the Singapore Elderly) conducted in 2013 and 2023. The treatment gap was defined as the proportion of 10/66 dementia cases without a self-reported prior clinical diagnosis. The dementia treatment gap narrowed significantly, decreasing by 19.1% over the decade. However, improvements were largely driven by better diagnosis of moderate to severe dementia (25.3% of treatment gap attributable to Coefficients); in contrast, Coefficients were negative for no/questionable (−10.7%) and mild (−15.1%) dementia, indicating gaps in the diagnosis of early-stage dementia leading to the treatment gap. Over the past decade, Singapore has successfully narrowed its dementia treatment gap, primarily by mitigating socioeconomic barriers and enhancing the detection of moderate-to-severe cases.