An in-home geriatric programme for vulnerable community-dwelling older people improves the detection of dementia in primary care.
OBJECTIVE
Dementia is under-diagnosed in primary care. This study investigated whether an in-home geriatric assessment and management programme could improve the identification of patients with dementia in primary care.


METHODS
A secondary analysis was performed, using data of a randomised controlled trial that studied the effects of an in-home geriatric evaluation and management programme compared with usual care. In this trial, 151 vulnerable community-dwelling patients, aged 70 years and older, participated: 86 in the intervention group and 66 in de control group. The effect of the programme on the dementia detection rate was determined by comparing the number of new dementia diagnoses in both study arms at 6 months follow-up.


RESULTS
Of all 151 participants, 38 (25%) had a registered dementia diagnosis at baseline. During follow-up, 23 of 113 patients without a registered dementia diagnosis at baseline were identified as suffering from dementia. The difference between the numbers of new dementia diagnoses in the intervention group (19 of 66 patients) and the control group (4 of 47 patients) was significant. (p = 0.02)


CONCLUSIONS
An in-home geriatric assessment and management programme for vulnerable older patients improves the detection of dementia and can therefore contribute to overcoming of under-diagnosis of dementia.
Department of Geriatric Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. m.perry@ger.umcn.nl
M
M
Perry
R J F
RJ
Melis
S
S
Teerenstra
I
I
Drasković
T
T
van Achterberg
M I J
MI
van Eijken
P
P
Lucassen
M G M Olde
MG
Rikkert
D000369:Aged, 80 and over; D003704:Dementia / Q000175:diagnosis* / Q000191:economics; D042241:Early Diagnosis; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006299:Health Services for the Aged; D006699:Home Care Services; D006801:Humans; D008297:Male; D011320:Primary Health Care / Q000191:economics; D015397:Program Evaluation; D014504:Urban Health