Identification and diagnostic evaluation of possible dementia in general practice

Author: Waldorff Frans Boch   Rishøj Susanne   Waldemar Gunhild  

Publisher: Informa Healthcare

ISSN: 0281-3432

Source: Scandinavian Journal of Primary Health Care, Vol.23, Iss.4, 2005-12, pp. : 221-226

Disclaimer: Any content in publications that violate the sovereignty, the constitution or regulations of the PRC is not accepted or approved by CNPIEC.

Previous Menu Next

Abstract

Objective. To investigate the rate of diagnostic evaluation of dementia for patients in whom a suspicion of dementia was raised, and to investigate reasons why a diagnostic evaluation was not always being performed. Design. A prospective study among elderly patients aged 65+, and a follow-up study. Setting. In all, 17 general practices in Copenhagen with 40 865 patients on their lists of whom 2934 were aged 65+. Subjects. A total of 793 patients consulting their GP regardless of reason of encounter, in October and November 2002. Main outcome measures. MMSE score ≤ 23, GP clinical impression of dementia, laboratory-screening tests prescribed by the GPs and referral status after 6 months, and follow-up questionnaire. Results. Of 793 patients a total of 138 patients were identified with possible dementia. Among the identified patients 26 (20%) were referred for further evaluation within 6 months, and 4 (3%) were treated for depression or referred for another condition. A total of 6 patients were lost to follow up. In the remaining 102 undiagnosed patients the main reasons for not performing a diagnostic evaluation of dementia were patient/relative hesitation (34%), the GP thought that it would not have any consequences for the patient, or the GP estimated that the patient was too fragile (21%). Conclusion. In 17% of elderly patients in general practice a suspicion of dementia could be raised based on the clinical impression of the GP or MMSE score. However, only 23% of this group were evaluated by their GP or referred to a memory clinic within a subsequent period of 6 months.

Related content