Back to Search
Start Over
Implementing a screening and diagnosis program for dementia in primary care.
- Source :
- JGIM: Journal of General Internal Medicine; Jul2005, Vol. 20 Issue 7, p572-577, 6p
- Publication Year :
- 2005
-
Abstract
- <bold>Background: </bold>Primary care physicians are positioned to provide early recognition and treatment of dementia. We evaluated the feasibility and utility of a comprehensive screening and diagnosis program for dementia in primary care.<bold>Methods: </bold>We screened individuals aged 65 and older attending 7 urban and racially diverse primary care practices in Indianapolis. Dementia was diagnosed according to International Classification of Diseases (ICD)-10 criteria by an expert panel using the results of neuropsychologic testing and information collected from patients, caregivers, and medical records.<bold>Results: </bold>Among 3,340 patients screened, 434 scored positive but only 227 would agree to a formal diagnostic assessment. Among those who completed the diagnostic assessment, 47% were diagnosed with dementia, 33% had cognitive impairment-no dementia (CIND), and 20% were considered to have no cognitive deficit. The overall estimated prevalence of dementia was 6.0% (95% confidence interval (CI) 5.5% to 6.6%) and the overall estimate of the program cost was $128 per patient screened for dementia and $3,983 per patient diagnosed with dementia. Only 19% of patients with confirmed dementia diagnosis had documentation of dementia in their medical record.<bold>Conclusions: </bold>Dementia is common and undiagnosed in primary care. Screening instruments alone have insufficient specificity to establish a valid diagnosis of dementia when used in a comprehensive screening program; these results may not be generalized to older adults presenting with cognitive complaints. Multiple health system and patient-level factors present barriers to this formal assessment and thus render the current standard of care for dementia diagnosis impractical in primary care settings. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 08848734
- Volume :
- 20
- Issue :
- 7
- Database :
- Complementary Index
- Journal :
- JGIM: Journal of General Internal Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 17518779
- Full Text :
- https://doi.org/10.1007/s11606-005-0103-7