Improving Diagnosis and Treatment of Dementia in Primary Care

Overview

In the Czech Republic, more than 100 000 persons suffer from dementia and every year this number increases by 25 000. Despite the high prevalence of dementia in the elderly population and serious health and sodo-economic consequences dementia is diagnosed late or not at all in clinical practice. The general practitioner plays a key role in the initial evaluation, treatment and long-term management of dementia. The aim of the questionnaire survey in a sample of 450 general practitioners was to map the current situation in the CR. Knowledge and attitudes of general practitioners towards dementia esere assessed and causes of late and incorrect diagnosis determined.An alarming is the finding tkat the correct diagnosis is not established in 60-75% of demented subjects with all negative consequences for the patient. In majority of diagnosed cases diagnosis is made late when severe behavioural disturbances dominate and symptomatic treatment with psychotropic mainly neuroleptic drugs is needed. Main causes of this situation - according to general practitioners - are insufficient knowledge, difficulty in differentiating dementia from signs of „normal ageing", small willingness to evaluate cognitive functions in elderly patients, poor knowledge of diagnostic tests and insufficient resources for diagnostic processes and treatment. Suggestions of primary care physicians for improvement of this situation are discussed.

Key words:
dementia - diagnosis of dementia - general practitioners.