• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Logo of bmjLink to Publisher's site
BMJ. Oct 29, 1988; 297(6656): 1107–1110.
PMCID: PMC1834835

Do general practitioners miss dementia in elderly patients?

Abstract

General practitioners and community nurses were asked to rate the likelihood of dementia for each of their elderly patients. Cases of dementia were identified by research psychiatrists using the Cambridge mental disorders of the elderly examination (CAMDEX), a new structured diagnostic interview. General practitioners correctly identified dementia as at least a possibility in 121 of the 208 cases found. Nevertheless, they mistakenly rated as demented several patients suffering from functional psychiatric disorders, in particular depression. Community nurses correctly identified dementia as at least a possibility in 64 of the 74 demented patients known to them, but they incorrectly suspected dementia in a greater proportion of instances. Both general practitioners and families appeared to have low expectations of what general practice has to offer demented elderly people. General practitioners should take the initiative in diagnosing dementia in very elderly patients who show signs of the condition. In some cases it may be secondary to treatable disorders, and in others all that may be required are understanding, support, and advice to families.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (985K), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • WILLIAMSON J, STOKOE IH, GRAY S, FISHER M, SMITH A, MCGHEE A, STEPHENSON E. OLD PEOPLE AT HOME. THEIR UNREPORTED NEEDS. Lancet. 1964 May 23;1(7343):1117–1120. [PubMed]
  • Huppert FA, Tym E. Clinical and neuropsychological assessment of dementia. Br Med Bull. 1986 Jan;42(1):11–18. [PubMed]
  • Anthony JC, LeResche L, Niaz U, von Korff MR, Folstein MF. Limits of the 'Mini-Mental State' as a screening test for dementia and delirium among hospital patients. Psychol Med. 1982 May;12(2):397–408. [PubMed]
  • Folstein M, Anthony JC, Parhad I, Duffy B, Gruenberg EM. The meaning of cognitive impairment in the elderly. J Am Geriatr Soc. 1985 Apr;33(4):228–235. [PubMed]
  • Roth M, Tym E, Mountjoy CQ, Huppert FA, Hendrie H, Verma S, Goddard R. CAMDEX. A standardised instrument for the diagnosis of mental disorder in the elderly with special reference to the early detection of dementia. Br J Psychiatry. 1986 Dec;149:698–709. [PubMed]
  • Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969 Autumn;9(3):179–186. [PubMed]
  • MacDonald AJ. Do general practitioners "miss" depression in elderly patients? Br Med J (Clin Res Ed) 1986 May 24;292(6532):1365–1367. [PMC free article] [PubMed]
  • Isaacs B. Geriatric patients: do their families care? Br Med J. 1971 Oct 30;4(5782):282–286. [PMC free article] [PubMed]
  • Kay DW, Bergmann K, Foster EM, McKechnie AA, Roth M. Mental illness and hospital usage in the elderly: a random sample followed up. Compr Psychiatry. 1970 Jan;11(1):26–35. [PubMed]
  • Parmar H, Edwards L, Phillips RH, Allen L, Lightman SL. Orchiectomy versus long-acting D-Trp-6-LHRH in advanced prostatic cancer. Br J Urol. 1987 Mar;59(3):248–254. [PubMed]
  • Stein BS, Smith JA., Jr DES lead-in to use of luteinizing hormone releasing hormone analogs in treatment of metastatic carcinoma of prostate. Urology. 1985 Apr;25(4):350–353. [PubMed]
  • Boccon-Gibod L, Laudat MH, Dugue MA, Steg A. Cyproterone acetate lead-in prevents initial rise of serum testosterone induced by luteinizing hormone-releasing hormone analogs in the treatment of metastatic carcinoma of the prostate. Eur Urol. 1986;12(6):400–402. [PubMed]

Articles from BMJ : British Medical Journal are provided here courtesy of BMJ Group

Formats:

Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...

Links

  • Cited in Books
    Cited in Books
    PubMed Central articles cited in books
  • MedGen
    MedGen
    Related information in MedGen
  • PubMed
    PubMed
    PubMed citations for these articles

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...