[Non-detected dementia and use of the health services: implications for primary care].
OBJECTIVE
To calculate the proportion of cases of dementia detected in people over 70 living in their homes and to describe the use made by people with dementia of the health and social services.


METHODS
Population survey of the survivors of the cohort "Growing old in Leganés", started in 1993. In the third monitoring (1999-2000), the clinical diagnosis of dementia on the basis of a neurological examination and an extensive neuro-psychological battery was included. Their use of health and social services and prior diagnoses were also asked.


RESULTS
In the sample of survivors (n=527), there was 12.1% prevalence of dementia. Only 30% of the demented had previously been diagnosed by the health services. The proportion of undetected dementia was significantly associated with its seriousness (light 95%, moderate 69%, severe 36%). Compared with older persons who were not demented, the demented used more often hospital services, medical and nursing consultations at home and consultations through third parties; and less often, preventive and rehabilitation services. This trend was accentuated in patients with grave dementia. The use of community social services was very low (below 8% in the most serious cases).


CONCLUSIONS
The detection of dementia in the elderly is very low and efforts to detect it in primary care need to be stepped up. Specific social-health resources for this population also need to be increased and the attendance guide-lines for primary care teams, and for health professionals in general, need to be changed.
Zunzunegui Pastor
M V
MV
TAISS. Técnicas Avanzadas en Investigación en Servicios de Salud. Madrid. España. vzunzunegui@taiss.com
del Ser
T
T
Rodríguez Laso
A
A
García Yébenes
M J
MJ
Domingo
J
J
Otero Puime
A
A
D000368:Aged; D000369:Aged, 80 and over; D003625:Data Collection; D003704:Dementia / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006299:Health Services for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011320:Primary Health Care / Q000706:statistics & numerical data*; D013030:Spain / Q000453:epidemiology