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05-08-2010 | General practice | Article

Earlier detection of dementia needed


Free abstract

People with dementia are being diagnosed too late by GPs, suggests research showing that sufferers die sooner after diagnosis than previously thought.

The study also revealed that dementia patients have over three times higher mortality than other people in the first year after diagnosis, which the study authors say may reflect "diagnoses made at times of crisis or late in the disease trajectory".

Lead author Dr Greta Rait, from the Medical Research Council General Practice Research Framework, commented: "Until now most survival estimates have come from studies where people have been actively screened for dementia but the reality is that medical care for dementia patients tends to fall with family doctors. GPs are going to be dealing with more and more dementia cases in future and primary care must get better at detection."

Dr Rait and colleagues studied over 130,000 patients aged 60 years or older from around 350 UK general practices. As reported in the British Medical Journal, they found that the median survival of people diagnosed aged 65-69 years was 6.9 years and in those at 90 years or older, 1.9 years. These rates compared with 10.7 years and 3.8 years, respectively, in a recent study of people with dementia detected through screening.

Also, their study showed that adjusted mortality was 3.68-fold higher in the first year and 2.49-fold higher in the second year after diagnosis in people with dementia compared with people without the disease who were matched for practice and time period.

Commenting on the research, Royal College of GPs Chair Professor Steve Field said: "This is a really important piece of work; the number of patients with dementia coming to see their GPs is increasing year on year, and it will have an enormous impact on the patients, their families, the work of health professionals and the economy in years to come."

He said that the College's curriculum should improve dementia training but was currently too short.

"It's crucial that GPs have the appropriate knowledge and skills - learning about dementia is an important part of a GP's training - but GPs need to maintain this knowledge, and keep up to date so that they can identify patients with dementia at the earliest opportunity, and offer them early intervention so to help them live high-quality, fulfilling lives for as long as possible."

GP News is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Caroline Price