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Deficient dementia care offered by General Practitioners

Horst C. Vollmar and colleagues report very low detection and recognition rates of dementia in General Practice settings. "Therapeutic actions and psychosocial supply have been found to be rarely considered and offered to patients and caregivers by General Practitioners", the scientists notice in the textbook "Dementia Care Research".

"Results of the German AgeCoDe study suggest that the General Practitioner´s judgement on patients´ cognitive status is biased: Less familiar patients, less mobile patients, patients with impaired hearing, and patients with greater co-morbidity were more likely to be rated as cognitively impaired by their General Practitioners, independent from cognitive test performance.
In another study we showed that overall sensivity of the General Practitioner´s judgement in identifying early dementia cases was 51,4%, specifity 95,9%, positive predictive value 23,6%, and negative predictive value 98,8%. General Practitioners missed dementia more frequently in patients living alone. General Practitioners overrated the presence of dementia more frequently in patients with problems in mobility or hearing, in patients with memory complaints and in patients with documented depression.
Apart from the patient-sided factors, there are manifold physician-sided factors that are helpful to explain the deficient dementia care. Limited beliefs in efficient pharmacologic intervention and the resulting reluctance to early recognition, the perceived discomfort of disclosure, the perceived burden of managing dementia patients and their caregivers, gaps in knowledge, and insufficient diagnostic and/or communication skills are only some of the discussed barriers ..."

Dementia Care Research
Scientific Evidence, Current Issues and Future Perspectives
Jochen René Thyrian & Wolfgang Hoffmann (Eds.)