Identification and diagnostic evaluation of possible dementia in general practice. A prospective study.
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.


METHODS
A prospective study among elderly patients aged 65+, and a follow-up study.


METHODS
In all, 17 general practices in Copenhagen with 40 865 patients on their lists of whom 2934 were aged 65+.


METHODS
A total of 793 patients consulting their GP regardless of reason of encounter, in October and November 2002.


METHODS
MMSE score < or = 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%).


CONCLUSIONS
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.
Waldorff
Frans Boch
FB
Research Unit and Department of General Practice, Institute of Public Health, University of Copenhagen, Øster Farimagsgade 5, PO Box 2099, DK-1014 Copenhagen K, Denmark. fbw@gpract.ku.dk
Rishøj
Susanne
S
Waldemar
Gunhild
G
D000368:Aged; D003704:Dementia / Q000175:diagnosis*; D005194:Family Practice; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D010865:Pilot Projects; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012017:Referral and Consultation; D011795:Surveys and Questionnaires