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Early diagnosis of dementia in primary care: a representative eight‐year follow‐up study in Lower Saxony, Germany
Author(s) -
Maeck Lienhard,
Haak Sebastian,
Knoblauch Anita,
Stoppe Gabriela
Publication year - 2007
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.1646
Subject(s) - dementia , medicine , primary care , gerontology , pediatrics , family medicine , disease
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.