Design: Qualitative study, semi-structured and group interviews
Population: 56 people with dementia, carers and primary care professionals in England
Primary outcome: How anxiety and depression in dementia are identified
Effect: Themes: symptom overlap, attribution to dementia, stigma in help-seeking

A qualitative study in the British Journal of General Practice, published on 26 October 2026, interviewed 56 people in England: people with dementia and anxiety or depression, their carers, and primary care and social care professionals.

All groups described how hard it is to separate anxiety and depressive symptoms from cognitive impairment, which could delay a dementia diagnosis in the first place. Once dementia was diagnosed, professionals and carers often attributed low mood or anxiety to it, while other illnesses and personality also shaped how symptoms appeared. Changes in behaviour and emotional response over time helped recognition. Stigma, culture, denial and masking held back help-seeking.

This is qualitative work and does not measure how often symptoms are missed. Its value is in naming the habit of attribution, which a GP can check in their own practice.

Ask directly about mood and worry at dementia reviews, rather than waiting for them to be raised.
Use carer reports of change in behaviour or emotional response as a prompt to assess mood.
Look for other causes — pain, infection, medication, sensory loss — before attributing distress to dementia.
Consider cultural and stigma barriers when a family is reluctant to discuss mood.

Why it matters

Treatable distress is easily absorbed into a dementia label and left untreated.

The statistics, in plain English

This is a qualitative interview study; it describes experiences and themes rather than measuring rates, so it cannot say how common missed diagnoses are.