Research suggests dementia is still underdiagnosed and referral to specialists occurs late and often in crisis, despite increasing evidence that sufferers and carers want early intervention and advice. A questionnaire designed to survey attitudes to dementia was completed by 35 consultants in old age psychiatry across Scotland and a representative sample of 35 general practitioners in Glasgow. The results indicated that general practitioners' and psychiatrists' attitudes to dementia differed significantly in several aspects. The majority of general practitioners felt that they had little to otrer dementia patients, that early referral was unhelpful, that easier access to long-term beds was needed and that the problem was mainly social. In contrast, the majority of consultants supported early referral and diagnosis, strongly felt help could be offered, saw dementia as having both medical and social aspects and were divided regarding ease of admission for continuing care. These differences and possible implications for the delivery of optimum care are discussed.
KEY WORDS-old age psychiatry, general practitioners, dementia, attitudes.
Although general practitioners are gatekeepers to most of the services available to their dementing patients, little is known about their attitude to dementia, or to their own role as service providers. Neither is it known to what extent, if at all, these attitudes differ from those of the old age psychiatrists to whom they refer patients.
It is now recognized that general practitioners do detect more dementia in the community than was suggested by Williamson et al. (1964), but there is still evidence that the condition is underdiagnosed. Two recent studies by Iliffe et af. (1991) andO'Connor et al. (1988) found that the diagnosis, even when known, was rarely recorded in practice case records or mentioned in referral letters to general hospital clinics. We do not know whether little value is seen in making a formal diagnosis,