title: Sooner or later? Issues in the early diagnosis of dementia in general practice: a qualitative study.
abstract: OBJECTIVE
  The aim of this study was to explore the perspectives of primary care practitioners on the early diagnosis of dementia.
  
  
  METHODS
  A total of 247 GPs, 146 community nurses, 36 practice nurses, 79 community mental health nurses and others working in a range of hospital, residential and community settings attended 24 one-day workshops in 21 cities and towns in the UK. A nominal group approach was used relating to the early diagnosis of dementia in the community.
  
  
  RESULTS
  Groups agreed on the benefits and risks of early diagnosis of dementia; disagreed about screening for dementia, and about professional resistance to making the diagnosis; constructed comprehensive guidelines on diagnosis, but without much reference to resource implications; yet described actual local resource limitations in detail; and avoided dilemmas about dementia care by framing it as a specialist activity.
  
  
  CONCLUSIONS
  Practitioners situate dementia in a family context but do not yet use a disablement model of dementia which might reduce tensions about early diagnosis and the disclosure of the diagnosis. The term diagnosis could usefully be replaced by recognition, to aid this shift in model. Service gaps may emerge or widen if earlier diagnosis of dementia is pursued as a policy objective.
authors.affiliation: Royal Free and UCL Medical School, Rowland Hill Street, London NW3 2PF, UK. s.iliffe@pcps.ucl.ac.uk
authors.forename: Steve
authors.initials: S
authors.lastname: Iliffe
authors.forename: Jill
authors.initials: J
authors.lastname: Manthorpe
authors.forename: Alison
authors.initials: A
authors.lastname: Eden
mesh_terms: D001291:Attitude of Health Personnel; D003704:Dementia / Q000175:diagnosis*; D042241:Early Diagnosis; D005194:Family Practice; D006801:Humans; D008403:Mass Screening; D011320:Primary Health Care; D040841:Resource Allocation; D018570:Risk Assessment; D006113:United Kingdom; D000078329:Workforce