3.8 Article

Early recognition or screening of dementia in general practice

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THERAPEUTISCHE UMSCHAU
卷 78, 期 2, 页码 73-81

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HOGREFE AG-HOGREFE AG SUISSE
DOI: 10.1024/0040-5930/a001241

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General practitioners play a crucial role in timely dementia diagnosis, relying on their perception of warning signs. Early detection of dementia symptoms should prompt neuropsychological and medical evaluations, providing a basis for further diagnosis and treatment.
General practitioners play a key role in timely dementia diagnosis. In view that there are currently no drugs to prevent the progression of dementia or are effective in patients with mild cognitive impairment, a general screening of older people to recognize pre-symptomatic stages of dementia is not recommended. Crucial for a timely diagnosis is the GP's perception of warning signs, so-called red flags. If the patients, family members, authorities or even the GP notice even discreet signs of a possible early dementia, a neuropsychological and medical evaluation should be initiated. Personal history, history by informant, a physical examination, supplemented by a GP's psychiatric evaluation and ideally the careful assessment with the MoCA form the basis of a preliminary clarification in general practice. If dementia is suspected, this clarification should be supplemented by an in-depth laboratory examination and, if applicable, neuroimaging before the patient is referred, depending on the findings, to a memory clinic or a consultant specialist to confirm the diagnosis and if appropriate initiate pharmacological and non-pharmacological therapies.

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