The early diagnosis of dementia: triggers, early signs and luxating events.

BACKGROUND: In order to make it possible and feasible that GPs diagnose dementia at an earlier phase than usual, it is important to know what elements in the available information on the patient and the family may trigger the diagnostic hypothesis of dementia.
METHOD: By qualitative research, the stories of family members of dementia patients, according to DSM-III-R criteria, were analysed. RESULTS AND
CONCLUSIONS: This work produced the following hypotheses: disturbances in functioning at work and ADL-IADL disturbances, the seeking of the carer's support and emotional problems-in addition to the more classical memory problems-are early signs and may be essential triggers for the GP to consider the possibility of an emerging dementia. Change of medication, narcosis, loss of the carer and hospital admission are luxating moments for the sudden appearance of symptoms and disturbances caused by dementia. Further research should be carried out to develop instruments for the early detection of dementia that step across neuropsychological tests and are feasible for daily use in a primary care setting.