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.
RCT Entities:
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.
Authors: Andrea Bradford; Mark E Kunik; Paul Schulz; Susan P Williams; Hardeep Singh Journal: Alzheimer Dis Assoc Disord Date: 2009 Oct-Dec Impact factor: 2.703
Authors: Gustav Kamenski; Thomas Dorner; Kitty Lawrence; Georg Psota; Anita Rieder; Franz Schwarz; Asita Sepandj; Wolfgang Spiegel; Stefan Strotzka Journal: Ment Health Fam Med Date: 2009-12
Authors: H Villars; S Oustric; S Andrieu; J P Baeyens; R Bernabei; H Brodaty; K Brummel-Smith; C Celafu; N Chappell; J Fitten; G Frisoni; L Froelich; O Guerin; G Gold; I Holmerova; S Iliffe; A Lukas; R Melis; J E Morley; H Nies; F Nourhashemi; J Petermans; J Ribera Casado; L Rubenstein; A Salva; C Sieber; A Sinclair; R Schindler; E Stephan; R Y Wong; B Vellas Journal: J Nutr Health Aging Date: 2010-02 Impact factor: 4.075