Early diagnosis of dementia in primary care: a representative eight-year follow-up study in Lower Saxony, Germany

✍ Scribed by Lienhard Maeck; Sebastian Haak; Anita Knoblauch; Gabriela Stoppe

• Publisher: John Wiley and Sons
• Year: 2006
• Tongue: English
• Weight: 171 KB
• Volume: 22
• Category: Article
• ISSN: 0885-6230
• DOI: 10.1002/gps.1646

✦ Synopsis

Abstract

Objective

To investigate whether primary care competency in early diagnosis of dementia might have changed during 1993 and 2001.

Method

By means of a representative follow‐up survey 122 out of 170 (71.8%) family physicians (FPs) in Lower Saxony, Germany, were randomly assigned to two written case samples presenting a patient with mild cognitive impairment (case 1a vs. 1b: female vs. male patient) and moderate dementia (case 2a vs 2b: vascular type (VD) vs Alzheimer's disease (DAT)), respectively. By means of a structured face‐to‐face interview, they were asked for their diagnostic considerations.

Results

In comparison to 1993, dementia was significantly more frequently considered. However, there was a striking tendency in overestimating vascular aetiology and under‐diagnosing probable DAT (case 1a/1b: DAT: 11.0% in 1993 vs 26.2% in 2001; VD: 2.1% in 1993 vs 17.2% in 2001). As a possible contributor to a dementia syndrome, concomitant medication was considered only exceptionally (case 2a/2b: 4.4% in 1993 vs 2.5% in 2001). Physicians above 50 years of age showed a significantly lower early diagnostic awareness. At follow‐up, the presumed interest in geriatric (psychiatric) topics dramatically faded from 66.9% to 35.2%.

Conclusions

Our results demonstrate a persistent need of training efforts aiming at the early recognition of dementia, especially of DAT, in primary care. Copyright © 2006 John Wiley & Sons, Ltd.