The Detection of Dementia in the Primary Care Setting

Valcour, Victor; Masaki, Kamal; Curb, J. David; Blanchette, Patricia L.

doi:10.1001/archinte.160.19.2964

Cited by 431 publications

(339 citation statements)

References 26 publications

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“…3 However, studies show that patients with dementia are not diagnosed, especially by a general practitioner. [4][5][6] In Brazil, a single published study showed that cognitive decline of the elderly is infrequently detected by general practitioners. 4 Many physicians who have recently graduated from medical school opt for working in the Brazilian Public Health System, which is responsible for attending to about 75% of the population.…”

Section: Introductionmentioning

confidence: 99%

Knowledge and attitudes towards dementia among final-year medical students in Brazil

Jacinto

Cítero

Neto

et al. 2017

Rev. Assoc. Med. Bras.

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Summary Objective: Among all countries, Brazil is expected to have the sixth largest elderly population in 2025. Dementia syndromes are prominent among aging-related diseases. Despite the necessity of and curriculum for training in geriatric medicine to make recommendations on an approach to this theme, adequate training appears to be infrequent. The present study aimed to evaluate the knowledge about dementia and students' attitude towards it during the last semester of the medical course in two of the most important Brazilian medical schools. Method: In our study, a sample of 189 students was invited to complete questionnaires comprising demographic and professional topics, knowledge with respect to cognitive alterations in the elderly and attitudes in dealing with an elderly patient with dementia. Results: A total of 155 students accepted to participate in the study; 92(59.7%) considered that they had good training in cognitive alterations during their undergraduate medical course, while 67 (58.8%) of them declared having had only theoretical training. Regarding knowledge, the students obtained a mean of 6.9, out of a scale from 0 to 14 points. As for attitudes, the students agreed that they can contribute to the life quality of the patient and of the caregiver, and that it is useful to provide the diagnosis to the family. Conclusion: The findings of this study are relevant for overturn the educational barriers of physicians in relation to the care of patients with dementia.

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Section: Introductionmentioning

confidence: 99%

Knowledge and attitudes towards dementia among final-year medical students in Brazil

Jacinto

Cítero

Neto

et al. 2017

Rev. Assoc. Med. Bras.

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“…Even though general practitioners are able to properly refer patients with cognitive disturbance to specialized clinics, they are often unable to diagnose the dementia syndrome 1,2 . Nowadays there are many multidisciplinary outpatient clinics specialized in the attendance of patients with cognitive/behavioral disorders in universities environments [3][4][5] .…”

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confidence: 99%

Clinical and demographic features of patients with dementia attended in a tertiary outpatient clinic

Vale

Miranda

2002

Arq. Neuro-Psiquiatr.

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-We describe clinical and socio-demographic features of patients with dementia attended in a tertiary outpatient clinic during a three years period (56.9% of the total attendance). Most of them were men, white, from the local community, urban district. Nobody had a job at the moment, two thirds of them got social welfare benefit. They lived with their family, the caregiver being the spouse or a daughter. The education level was very low, a quarter of them being illiterate. They were referred mostly from the public health care service, by neurologists or psychiatrists due to cognitive disorders. Family history as well as individual history of previous neurological/psychiatric disorders were frequent, especially alcoholism, stroke, head trauma and dementia. The neurological exam showed abnormalities in two thirds of cases, chiefly extra-pyramidal and pyramidal signs. Alzheimer's disease was the most frequent cause, followed by cerebrovascular disorder; alcoholism and normal pressure hydrocephalus were also frequent causes. Most patients presented concomitant non-etiological neurological/psychiatric disorders, mainly alcoholism and depression, and non-neurological/ psychiatric diseases, predominantly hypertension, cardiopathy and diabetes. Most patients had been referred under medication, frequently politherapy, including psychotropics.KEY WORDS: dementia, Alzheimer's disease, vascular dementia, epidemiology, tertiary outpatient clinic.Características clínicas e demográficas de pacientes com demência atendidos em ambulatório terciário Características clínicas e demográficas de pacientes com demência atendidos em ambulatório terciário Características clínicas e demográficas de pacientes com demência atendidos em ambulatório terciário Características clínicas e demográficas de pacientes com demência atendidos em ambulatório terciário Características clínicas e demográficas de pacientes com demência atendidos em ambulatório terciário RESUMO -São descritas características clínicas e sociodemográficas dos pacientes com demência de um ambulatório terciário, atendidos em período de três anos (56,9% de todos os atendimentos). Eram predominantemente do sexo masculino, cor branca, de procedência local, zona urbana. Nenhum permanecia trabalhando, dois terços recebiam benefício previdenciário. Residiam com familiares, o cuidador sendo cônjuge ou filha. Tinham escolaridade baixa, um quarto sendo analfabetos. Na maioria, eram provenientes da rede pública e referenciados por neurologistas ou psiquiatras, por distúrbios cognitivos. Antecedentes individuais ou familiares de transtornos neurológicos/psiquiátricos eram frequentes, destacando-se alcoolismo, doenças cerebrovascular, trauna crânio-encefalico e demência. Exame neurológico demonstrou anormalidades em dois terços, destacando-se sinais extra-piramidais e piramidais. Doença de Alzheimer era a etiologia mais frequente, seguida de doença cerebrovascular; alcoolismo e hidrocefalo de presão normal também eram frequentes. A maioria apresentava concomitantemente transtorn...

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“…The A&D Consensus Group addressed the well-documented and widely recognized problem of inadequate recognition of dementia in clinical practice [2][3][4][5][6]. Freund [7] estimated that the missed diagnoses are greater than 25% of the dementia cases and might be as high as 90%.…”

Section: The Clinical Evidence Justifies Screening For Dementiamentioning

confidence: 99%

Should older adults be screened for dementia? It is important to screen for evidence of dementia!

Ashford

Borson

O’Hara

et al. 2007

Alzheimer's & Dementia

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Multiple arguments for considering routine dementia screening have been presented. Furthermore, dementia diagnoses are widely unrecognized. As a result, persons with dementia are missing important clinical care and treatment interventions. By distinction, the problems of defining, diagnosing, and treating mild cognitive impairment (MCI) are not yet resolved, and MCI is not ready for a screening recommendation. Dementia screening approaches, including cognitive testing and functional assessment, must be evaluated on their scientific merits, including sensitivity and

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The Detection of Dementia in the Primary Care Setting

Abstract: Dementia is often unrecognized and undocumented in private practice settings. Arch Intern Med. 2000;160:2964-2968

Cited by 431 publications

References 26 publications

Knowledge and attitudes towards dementia among final-year medical students in Brazil

Knowledge and attitudes towards dementia among final-year medical students in Brazil

Clinical and demographic features of patients with dementia attended in a tertiary outpatient clinic

Should older adults be screened for dementia? It is important to screen for evidence of dementia!

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