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Differences in prevalence of dementia based on community survey and general practitioner recognition

Published online by Cambridge University Press:  09 July 2009

J. A. Eefsting ,
F. Boersma ,
W. Van Den Brink  and
W. Van Tilburg
J. A. Eefsting*
Affiliation:
Nursing Home and Rehabilitation Centre ‘Het Zonnehuis Zwolle’, the Amsterdam Institute for Addiction Research, Department of Psychiatry, University of Amsterdam, Department of Psychiatry, Free University of Amsterdam, The Netherlands
F. Boersma
Affiliation:
Nursing Home and Rehabilitation Centre ‘Het Zonnehuis Zwolle’, the Amsterdam Institute for Addiction Research, Department of Psychiatry, University of Amsterdam, Department of Psychiatry, Free University of Amsterdam, The Netherlands
W. Van Den Brink
Affiliation:
Nursing Home and Rehabilitation Centre ‘Het Zonnehuis Zwolle’, the Amsterdam Institute for Addiction Research, Department of Psychiatry, University of Amsterdam, Department of Psychiatry, Free University of Amsterdam, The Netherlands
W. Van Tilburg
Affiliation:
Nursing Home and Rehabilitation Centre ‘Het Zonnehuis Zwolle’, the Amsterdam Institute for Addiction Research, Department of Psychiatry, University of Amsterdam, Department of Psychiatry, Free University of Amsterdam, The Netherlands
*
1Address for correspondence: Dr J. A. Eefsting. Zwartewaterallee 20, 8031 DX Zwolle, The Netherlands.
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Synopsis

A study was conducted, which simultaneously used GPs and epidemiological assessment procedures (MMSE, CAMDEX), to identify individuals with DSM-III-R dementia in the same population. In addition, a 1-year follow-up assessment was conducted in patients with a CAMDEX-diagnosis of dementia. In the non-institutionalized group, which was assessed both by the GP and with the epidemiological test battery, the prevalence of dementia according to the GP was 2·2%, whereas the prevalence based on the epidemiological approach amounted to 5·2%. In general CAMDEX-diagnoses of dementia were confirmed at 1-year follow-up, and thus the discrepancy between the two prevalence estimates must be attributed to the low sensitivity of the GPs. Sensitivity of the GP was related to help-seeking behaviour, with low sensitivity in patients with a low contact rate. It was also related to the use of less specific diagnostic labels by the GP (cognitive impairment), and to poor recognition of cognitive impairment in patients who visited their GP.

Type
Original Articles
Information
Psychological Medicine , Volume 26 , Issue 6 , November 1996 , pp. 1223 - 1230
Copyright
Copyright © Cambridge University Press 1996

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References

American Psychiatric Association (1987). Diagnostic and Statistical Manual of Mental Disorders, 3rd edn., Revised. American Psychiatric Association: Washington, DC.Google Scholar
Beckett, L. A., Scherr, P. A. & Evans, D. A. (1992). Population prevalence estimates from complex samples. Journal of Clinical Epidemiology 45, 393–402.CrossRefGoogle ScholarPubMed
Clarfield, A. M. (1988). The reversible dementias: do they reverse? Annals of Internal Medicine 109, 476–486.CrossRefGoogle ScholarPubMed
Cooper, B., Bickel, H. & Schäufelc, M. (1992). The ability of general practitioners to detect dementia and cognitive impairment in their elderly patients: a study in Mannheim. International Journal of Geriatric Psychiatry 7, 591–598.CrossRefGoogle Scholar
Derix, M. M. A., Hofstede, A. B., Teunisse, S., Hijdra, A., Walstra, G. J. M., Weinstein, H. C. & Gool, W. A. van (1991). CAMDEX-N: de Nederlandse versie van de Cambridge Examination for Mental Disorders for the Elderly met geautomatiseerde data-verwerking. (Camdex N: the Dutch version of the Cambridge Examination for Mental Disorders of the Elderly with computerized data analysis). Tijdschrift voor Gerontologie en Geriatrie 22, 143–150.Google Scholar
Dunn, G. (1985). Records of psychiatric morbidity in general practice: The National Morbidity Surveys. Psychological Medicine 15, 223–336.CrossRefGoogle ScholarPubMed
Folstein, M. F., Folstein, S. E. & McHugh, P. R. (1975). ‘Mini-Mental State’. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research 12, 189–198.CrossRefGoogle Scholar
Galasko, D., Klauber, M. R., Hofstetter, C. R., Salmon, D. P., Lasker, B. & Thal, L. J. (1990). The Mini-Mental State Examination in the early diagnosis of Alzheimer's disease. Archives of Neurology 47, 49–52.Google Scholar
Hofman, A., Rocca, W. A., Brayne, C., Breteler, M. M. B., Clarke, M., Cooper, B., Copeland, J. R. M., Dartigues, J. F., da Silva Droux, A., Hagnell, O., Heeren, T. J., Engedal, K., Jonker, C., Lindesay, J., Lobo, A., Mann, A. H., Mölsa, P. K., Morgan, K., O'Connor, D. W., Sulkava, R., Kay, D. W. K. & Amaducci, L. (1991). The prevalence of dementia in Europe: a collaborative study of 1980–1990 findings. Eurodem Prevalence Research Group International Journal of Epidemiology 20, 736–748.Google ScholarPubMed
Hooyer, C., Dinkgreve, M., Jonker, C. & Lindeboom, J. (1992). Short screening tests for dementia in the elderly population. I. A comparison between AMTS, MMSE, MSQ and SPMSQ. International Journal of Geriatric Psychiatry 7, 559–571.Google Scholar
Isaacs, B. (1971). Geriatric patients: do their families care? British Medical Journal iv, 282–286.Google Scholar
Kay, D. W. K., Henderson, A. S., Scott, R., Wilson, J., Rickwood, D. & Grayson, D. A. (1985). Dementia an depression among the elderly living in the Hobart community: the effect of the diagnostic criteria on the prevalence rates. Psychological Medicine 15, 771–788.CrossRefGoogle ScholarPubMed
Lamberts, H., Brouwer, H., Groen, H. S. M. & Huisman, H. (1987). Het transitiemodel in de huisartspraktijk. (The transition model in general practice. Practical use of the ICPC in 28000 encounters.) Huisarts en Wetenschap 30, 105–113.Google Scholar
Larson, E. B., Reitler, B. V., Featherstone, H. J. & English, D. R. (1984). Dementia in elderly outpatients: a prospective study. Annals of Internal Medicine 100, 417–423.Google Scholar
Meyboom-de Jong, B. (1989). Bejaarde patienten. Een onderzoek in 12 huisartspraktijken. (Elderly patients. A study in 12 general practices.) Meditekst: Lelystad.Google Scholar
Muskens, J. B., Huygen, F. I. A. & Van Weel, C. (1991). De prevalentie van dementie bij ouderen. Een literatuuronderzoek naar het verschil tussen gegevens uit huisartsregistratieprojecten en uit onderzoek in open populaties. (The prevalence of dementia in elderly patients. A literature study of the difference between data from GP records and studies of open populations.) Huisarts en Wetenschap 34, 491–499.Google Scholar
O'Connor, D. W., Pollitt, P. A., Hyde, J. B., Brook, C. P. B., Reiss, B. B. & Roth, M. (1988). Do general practitioners miss dementia in elderly patients? British Journal of Psychiatry 297, 1107–1110.Google Scholar
O'Connor, D. W., Pollitt, P. A., Hyde, J. B., Fellows, J. L., Miller, N. D., Brook, C. P. B., Reiss, B. B. & Roth, M. (1989). The prevalence of dementia as measured by the Cambridge Mental Disorders of the Elderly Examination. Acta Psychiatrica Scandinavica 79, 190–198.CrossRefGoogle ScholarPubMed
Roth, M., Tym, E., Mountjoy, C. Q., Huppert, F. A., Hendrie, H., Verma, S. & Goddard, R. (1986). Camdex: a standardized instrument for the diagnosis of mental disorder in the elderly with special reference to the early detection of dementia. British Journal of Psychiatry 149, 698–709.CrossRefGoogle Scholar
Royal College of General Practitioners (1975). Morbidity Statistics from General Practice. Second National Study 1971–1972. RCGP: London.Google Scholar
Royal College of General Practitioners (1985). Morbidity Statistics from General Practice. Third National Study 1981–1982. RCGP: London.Google Scholar
Schulte, B. P. M. (1989). Consensus Diagnostiek bij het dementie-syndroom. (Consensus diagnosing dementia.) Nederlands Tijdschrift voor Geneeskunde 133, 981–985.Google Scholar
Smith, J. S. & Kiloh, L. G. (1981). The investigation of dementia: results in 200 consecutive admissions. Lancet i, 824–827.Google Scholar
Uhlmann, R. F. & Larson, E. B. (1991). Effect of education on the Mini-Mental State Examination as screening test for dementia. Journal of the American Geriatrics Society 39, 876–880.CrossRefGoogle ScholarPubMed
Williamson, J., Stokoe, I. H., Gray, S., Fisher, M., Smith, A., McGhee, A. & Stephenson, E. (1964). Old people at home: their unreported needs. Lancet i, 1117–1120.CrossRefGoogle Scholar
Wind, A. W., Van Staveren, G., Schellevis, F. G., Jonker, C. & Van Eyk, J. T. M. (1994). The validity of the judgement of general practitioners on dementia. International Journal of Geriatric Psychiatry 9, 543–549.CrossRefGoogle Scholar
World Health Organization (1978). Mental Disorders: Glossary and Guide to their Classification in Accordance with the Ninth Revision of International Classification of Diseases (ICD-9). WHO: Geneva.Google Scholar