Diagnostic evaluation of dementia in the secondary health care sector.
BACKGROUND
We conducted a nationwide registry-based study of the quality of diagnostic evaluation for dementia in the secondary health care sector.


METHODS
Two hundred patients were randomly selected from the patient population (4,682 patients) registered for the first time with a dementia diagnosis in the nationwide hospital registries during the last 6 months of 2003. Through medical record review, we evaluated the completeness of the work-up on which the dementia diagnosis was based, using evidence-based dementia guidelines as reference standards.


RESULTS
Satisfactory or acceptable completion of the basic dementia work-up was documented in 51.3% of the patients. Only 11.5% of those with unsatisfactory work-up were referred to follow-up investigations. Dementia syndrome was confirmed in 88.5% of the cases, but correct subtypes were diagnosed in only 35.1%.


CONCLUSIONS
The adherence to clinical guidelines concerning dementia work-up is inadequate in the secondary health care sector. Our findings call for improvement in the organization of clinical dementia care, for education of specialists and for changes in attitude towards making a diagnosis of dementia.
Phung
Thien Kieu Thi
TK
Memory Disorders Research Group, Department of Neurology, Copenhagen University Hospital Rigshospitalet, DK-2100 Copenhagen, Denmark. thien.phung@mail.mcgill.ca
Andersen
Birgitte Bo
BB
Kessing
Lars Vedel
LV
Mortensen
Preben Bo
PB
Waldemar
Gunhild
G
D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D003071:Cognition / Q000502:physiology; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D003704:Dementia / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D003718:Denmark / Q000453:epidemiology; D017408:Guidelines as Topic; D006801:Humans; D008279:Magnetic Resonance Imaging; D008499:Medical Records; D009483:Neuropsychological Tests; D012015:Reference Standards; D012042:Registries; D015203:Reproducibility of Results; D013038:Specialization / Q000706:statistics & numerical data; D014057:Tomography, X-Ray Computed