Compelling evidence suggests that there are several structural and ideological obstacles that general practicioners encounter when attempting to diagnose dementia.
The barriers to the early diagnosis of dementia and diagnostic disclosure in primary care
Background: GPs are the gatekeepers to service provision for the elderly and the usual first point of contact with the health system for individuals with dementia and their carers.
Increasing evidence suggests that early diagnosis and timely intervention is beneficial, both for patients and carers. Despite this, there remains a need to overcome GPs' therapeutic nihilism surrounding dementia. GPs report that the most difficult problem with the management of dementia is the communication and disclosure of the dementia diagnosis.
Methods: An extensive literature review was performed to determine the barriers and enablers for diagnosis of dementia by GPs.
The Medline and Google Scholar databases were searched for peer reviewed articles published in English from January 1996 to 2009. No limitations were placed on sample size or response rate.
Qualitative and quantitative studies were included. A structured search methodology was used to locate the relevant body of publications and the search strategy allowed for the fact that a number of terms are used inter-changeably in the literature. Additional references were identified through hand searches of selected journals and bibliographies of relevant articles.
Results: Forty-nine papers met the inclusion criteria. Research indicates the barriers to the early diagnosis of dementia and diagnostic disclosure in primary care include:
- Negative attitude to dementia care/therapeutic nihilism
- StigmaDifficulties in differentiating normal ageing from dementia
- The paucity of specialist diagnostic services, especially in rural areas
- GPs lack of confidence or trainingLack of a recognized, time-efficient screening tool
- A perceived lack of need to determine a specific diagnosis
- Limited time
- Risk of misdiagnosis
- The patient's impaired ability to provide an accurate history and participate in self-care
- Perception that the patient cannot comprehend/cope with the diagnosisRisk of damaging the doctor-patient relationship
Conclusions: Compelling evidence suggests that there are several structural and ideological obstacles that GPs encounter when attempting to diagnose dementia. However, there is also evidence of factors which encourage diagnosis and disclosure. Future educational supports for GPs need to concentrate on both these areas.
About ICAD 2009
The 2009 Alzheimer's Association International Conference on Alzheimer's Disease (ICAD 2009) brings together more than 3,000 researchers from 70 countries to share groundbreaking research and information on the cause, diagnosis, treatment and prevention of Alzheimer's disease and related disorders. As a part of the Association's research program, ICAD 2009 serves as a catalyst for generating new knowledge about dementia and fostering a vital, collegial research community. ICAD 2009 will be held in Vienna, Austria at Messe Wien Exhibition and Congress Center
_________________________________________________
Related Content - What’s the Difference Between Alzheimer’s Disease and Dementia
- Test Your Memory for Alzheimer's (5 Best Self Assessment Tests)
- Alzheimer's What's the Use
- How to Listen to an Alzheimer's Patient
- Is Coconut Oil a Treatment for Alzheimer's Disease?
- How to Get an Alzheimer's Patient to Eat More Food
- Does the Combination of Aricept and Namenda Help Slow the Rate of Decline in Alzheimer's Patients
_________________________________________________
Original content Bob DeMarco, the Alzheimer's Reading RoomBob DeMarco is the Founder and Editor of the Alzheimer's Reading Room. Bob is a recognized Influencer, speaker, and expert in the Alzheimer's and Dementia Community Worldwide. Bob lives in Delray Beach, FL.
