OBJECTIVE: Are there any differences between family physicians (FP) and primary care neuropsychiatrists (NP) with regard to their diagnostic competence of early dementia? METHODS: Trained interviewers presented written case vignettes to 68 NP and 122 FP during a structured interview. The case history described an otherwise healthy 70 years old patient complaining about cognitive disturbances suggesting incipient dementia. RESULTS: The survey is representative with a high response rate (71.8% FP and 67.3% NP). In both physician groups a vascular disease concept prevailed although the patient had no vascular risk factors. For primary and differential diagnosis NP considered depression more often. Overall only about 50% of physicians considered Alzheimer dementia. Regarding diagnostic methods the NP adhered significantly better to the current guidelines. While 31% of FP would apply dementia screening and 12% order neuroimaging, 76% and 74% of the NP mentioned these methods, respectively. CONCLUSIONS: There are negligible differences between NP and HA with regard to early diagnostic awareness of dementia. Vascular concepts prevail. However, both groups differ with regard to the diagnostic work-up. An increase of competence seems to be necessary in both groups.
OBJECTIVE: Are there any differences between family physicians (FP) and primary care neuropsychiatrists (NP) with regard to their diagnostic competence of early dementia? METHODS: Trained interviewers presented written case vignettes to 68 NP and 122 FP during a structured interview. The case history described an otherwise healthy 70 years old patient complaining about cognitive disturbances suggesting incipient dementia. RESULTS: The survey is representative with a high response rate (71.8% FP and 67.3% NP). In both physician groups a vascular disease concept prevailed although the patient had no vascular risk factors. For primary and differential diagnosis NP considered depression more often. Overall only about 50% of physicians considered Alzheimer dementia. Regarding diagnostic methods the NP adhered significantly better to the current guidelines. While 31% of FP would apply dementia screening and 12% order neuroimaging, 76% and 74% of the NP mentioned these methods, respectively. CONCLUSIONS: There are negligible differences between NP and HA with regard to early diagnostic awareness of dementia. Vascular concepts prevail. However, both groups differ with regard to the diagnostic work-up. An increase of competence seems to be necessary in both groups.
Authors: Carolin Donath; Elmar Grässel; Maria Grossfeld-Schmitz; Petra Menn; Jörg Lauterberg; Sonja Wunder; Peter Marx; Stephan Ruckdäschel; Hilmar Mehlig; Rolf Holle Journal: BMC Health Serv Res Date: 2010-11-18 Impact factor: 2.655