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BMJ. 1988 Oct 29; 297(6656): 1107–1110.
PMCID: PMC1834835

Do general practitioners miss dementia in elderly patients?


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.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • 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]

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