Symptoms of preclinical dementia in general practice up to five years before dementia diagnosis.
OBJECTIVE
To investigate which symptoms are indicative of preclinical dementia in general practice and whether subjects with preclinical dementia have an increased contact frequency with their general practitioner (GP).


METHODS
Individuals with preclinical dementia (n = 75) and non-demented controls (n = 125) were selected from the Dutch GP registration network (RNH). Number of visits and odds ratio for the risk of subsequent dementia of various symptoms were analysed. Analyses were done separately for each 12-month period, in the 5 years prior to the diagnosis of dementia.


RESULTS
In the 5 years prior to diagnosis, subjects with preclinical dementia visited their GP more often than controls. Gait disturbances were the earliest predictor. Cognitive complaints were predictive for dementia in the 3 years before diagnosis. All other symptoms, except vascular symptoms, were predictive in the year prior to diagnosis. Sensitivity was highest for cognitive symptoms (0.58) and gait disturbances (0.47) in the year before diagnosis.


CONCLUSIONS
Preclinical dementia is associated with an increased contact frequency between patient and GP at least 5 years prior to the diagnosis of dementia. Gait disturbances and cognitive complaints are the earliest symptoms of preclinical dementia.
Ramakers
Inez H G B
IH
Department of Psychiatry and Neuropsychology, Institute of Brain and Behavior, Maastricht University, Maastricht, The Netherlands.
Visser
Pieter Jelle
PJ
Aalten
Pauline
P
Boesten
Jos H M
JH
Metsemakers
Job F M
JF
Jolles
Jelle
J
Verhey
Frans R J
FR
D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000209:etiology; D003704:Dementia / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology*; D005194:Family Practice; D005260:Female; D005684:Gait; D006801:Humans; D008297:Male; D009819:Office Visits / Q000706:statistics & numerical data; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D012680:Sensitivity and Specificity; D013997:Time Factors