Description of general practitioners' practices when suspecting cognitive impairment. Recourse to care in dementia (Recaredem) study

Aging Ment Health. 2018 Aug;22(8):1040-1049. doi: 10.1080/13607863.2017.1330871. Epub 2017 Jun 8.

Abstract

Objective: General practitioners (GPs) play a major role in the assessment of dementia but it is still unrecognized in primary care and its management is heterogeneous. Our objective is to describe the usual practices, and their determinants, of French GPs in this field.

Methods: GPs' characteristics and practices when facing cognitive decline were collected through a telephone interview and a postal questionnaire. A descriptive analysis of all study variables was conducted. The study of quantitative explanatory variables was done by testing the equality of means and the choice of qualitative variables was based on the chi-square independence test or Fischer test.

Results: Hundred two GPs completed the study. GPs were in majority men, working in urban areas. Mean age was 54.4 years old. GPs' feeling of confidence and self-perception of follow-up of national recommendations is linked with their practices. Performing a clinical interview to assess cognitive impairment is linked with good communication skills. GPs feel less confident to give information about resources for dementia. The main reason alleged for underdiagnosis is the limited effectiveness of drug therapy.

Conclusions: This study underlines the importance of GPs' feeling of confidence when managing cognitively impaired patients with dementia, and the need of increasing training in the field of dementia, which could improve the awareness of GPs about diagnosis and available resources.

Keywords: Dementia and cognitive disorders; primary care; screening and diagnosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Clinical Competence / statistics & numerical data*
  • Cognitive Dysfunction* / diagnosis
  • Cognitive Dysfunction* / therapy
  • Dementia* / diagnosis
  • Dementia* / therapy
  • Female
  • France
  • General Practitioners / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Primary Health Care / statistics & numerical data*