The role of referrals in diagnosing dementia at the primary care level.
BACKGROUND
Demographic changes indicating a general aging of the population suggest that the key role of general practitioners (GPs) in the diagnosis and management of dementia becomes more salient. The encouragement of GPs to collaborate with specialists is one chance to support GPs in performing a variety of functions associated with the diagnosis and management of dementia.


METHODS
We used a questionnaire to investigate the role of referrals in diagnosing dementia at the primary care level and variables potentially influencing the referral behavior of German GPs (n = 563).


RESULTS
Only 31% of the GPs stated that the diagnosis of dementia was made predominantly in the context of referral to a specialist. The chance that referrals were made was increased for those GPs who entertained extensive cooperative relationships with self-help groups, psychologists, or the "Alzheimer Society"/"Brain League" (odds ratio [OR] 1.74) and for those GPs who perceived a great preparedness on the part of the relatives of the patient to comply with a referral (OR 2.29) as well as who noticed a great readiness among specialists to accept patients for the diagnosis of dementia (OR 2.55). GPs whose therapeutic orientation was shaped by further training and scientific literature were more likely to refer (OR 3.54).


CONCLUSIONS
Enhancing the liaison between GPs and specialist physicians by improving the psychogeriatric competence of GPs as well as the connection to nonmedical services is discussed.
Riedel-Heller
S G
SG
Department of Psychiatry, University of Leipzig, Germany. ries@server3.medizin.uni-leipzig.de
Schork
A
A
Matschinger
H
H
Angermeyer
M C
MC
D000368:Aged; D003704:Dementia / Q000175:diagnosis*; D005260:Female; D005858:Germany; D006299:Health Services for the Aged / Q000592:standards*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D012017:Referral and Consultation; D011795:Surveys and Questionnaires