liu.seSearch for publications in DiVA
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Detection of Dementia in Primary Care: The Linköping Study
Linköping University, Department of Department of Health and Society, General Practice. Linköping University, Faculty of Health Sciences.
Department of Psychiatry, Institute of Clinical Neuroscience, Sahlgrenska University Hospital, Göteborg University, Göteborg, Sweden.
Linköping University, Department of Neuroscience and Locomotion, Geriatrics. Linköping University, Faculty of Health Sciences.
2000 (English)In: Dementia and Geriatric Cognitive Disorders, ISSN 1420-8008, E-ISSN 1421-9824, Vol. 11, no 4, 223-229 p.Article in journal (Refereed) Published
Abstract [en]

We examined to what extent dementia and cognitive impairment are detected in a primary health care centre. A systematic sample of patients aged 70 years and above, who attended a primary health care centre for a doctor’s consultation (n = 350) were examined with a neuropsychiatric examination and an interview with a close informant. Dementia was diagnosed according to DSM-III-R. Medical records from the health centre were examined for entries on cognitive decline or dementia, other diagnoses and prescribed drugs. The prevalence of dementia was 16.3% and a further 3.1% had questionable dementia. Cognitive disturbances or dementia were noted in case records in 15 out of 57 (26%) demented cases, and in 1 out of 11 (9%) questionable dementias. Compared to non-demented patients, the demented had more diagnoses and a higher number of prescribed drugs. Severity and duration of dementia were associated with an increased detection.

Place, publisher, year, edition, pages
2000. Vol. 11, no 4, 223-229 p.
Keyword [en]
dementia, primary care, detection, prevalence
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-27074DOI: 10.1159/000017241PubMedID: 10867449Local ID: 11721OAI: oai:DiVA.org:liu-27074DiVA: diva2:247625
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
In thesis
1. Dementia and Mental Disorders Among the Elderly in Primary Care
Open this publication in new window or tab >>Dementia and Mental Disorders Among the Elderly in Primary Care
2001 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The main pmpose of the present thesis was to investigate how elderly patients with dementia and mental disorders were managed in primary care. The prevalence of the disease was investigated, to what extent the patients and their disorders were detected and treated and the approach of general practitioners toward patients with dementia.

Patients aged 70 years and above visiting a primary care centre (PCC) in Linköping (N=1225) were examined with a Mini-Mental Status Examination (MMSE). In a subsample (N=350) a comprehensive neuro psychiatric examination and an interview with a close informant were conducted. All medical records (N=350) in the PCC were reviewed regarding diagnoses, medication and the number of visits to the centre. Dementia and mental disorders were diagnosed according to DSM-III-R. A postal questionnaire was sent out to all general practitioners (GPs) in the county of Östergötland (N=228) to gain information about their situation and attitudes regarding patients with dementia.

Using the traditional cut-off score of 23/24 points in the MMSE, revealed in a considerable under-diagnosing of demented patients in this study, leaving more than 70% of mild cases and 30% of moderate cases undetected. When using a cut-off score of 26/27 good criterion validity was found. There was excellent agreement between the testing by the social worker at the PCC and the GP in the patient's home.

The prevalence of dementia and mental disorder according to the psychiatdc interview was 33% (16% dementia, 17% mental disorders) The frequency of psychiatric symptoms among those with no mental disorder was up to 66%.

Dementia was detected in 25% of cases, depression in 12% of cases and anxiety in 30% of cases. The most common psychiatric diagnosis according to medical records was sleep disorder. Patients with dementia were older, had more other diagnoses as well as medication. Patients with mental disorder had more visits to the PCC.

The GPs underestimated the occurrence of dementia among elderly in PCC. They presented a positive attitude to managing patients with dementia and considered that existing dmg therapy justified an active search for patients with dementia in primary care. Assessment of patients' social enviromnent and the organisation of social support were regarded as the most difficult tasks in the management of demented patients.

The prevalence of dementia and mental disorders in an elderly PCC population is high. As the major problem in the management of dementia and mental disorder has been under-detection, MMSE as an opportunistic screening tool for cognitive function in this group is recommended.

The formation of an effective network, to manage the continuing care of patients with dementia is essential, and a dementia co-ordinator at the PCC would be preferable.

Place, publisher, year, edition, pages
Linköping: Linköpings universitet, 2001. 57 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 680
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-27532 (URN)12189 (Local ID)91-7219-976-8 (ISBN)12189 (Archive number)12189 (OAI)
Public defence
2001-05-31, Administrationsbyggnadens aula, Universitetssjukhuset, Linköping, 13:00 (Swedish)
Opponent
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2012-09-07Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed

Authority records BETA

Marcusson, Jan

Search in DiVA

By author/editor
Marcusson, Jan
By organisation
General PracticeFaculty of Health SciencesGeriatrics
In the same journal
Dementia and Geriatric Cognitive Disorders
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 222 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf