Dementia is a syndrome characterised by progressive cognitive impairment and is associated with impairment in functional abilities and in many cases, behavioural and psychological symptoms.
Dementia prevalence is rising. Ireland is predicted to have the largest growth in the older population of all European countries in the coming decades. In 2009, there were an estimated 41,700 people living with some form of dementia in Ireland. It is expected that this figure will rise to 147,000 by 2041. The average GP diagnoses one or two new patients with dementia each year and will have 12 to 15 patients with dementia in an average list size. Primary care dementia workload will inevitably increase as our population ages.
General Practitioners are often the first healthcare professionals to be consulted when dementia is suspected by patients or their families. Early recognition is not easy because of the insidious and variable onset of symptoms. Confirmation of the diagnosis can take up to four years. Irish GPs experience difficulty in diagnosing and disclosing a diagnosis of dementia to their patients citing difficulties differentiating normal ageing from symptoms of dementia, lack of confidence and concerns about the impact of the diagnosis on the patient.
Studies of GP learning needs have highlighted the need for dementia education, in particular around areas including the diagnosis, assessment of carers' needs, quality markers for dementia care in general practice, and assessment of mental capacity.
- Dementia prevalence is rising with resultant increase in general practice dementia workload.
- Timely diagnosis and early intervention is advocated by clinical guidelines and national strategies.
- A multidisciplinary approach to the diagnosis and management benefits patients with dementia.
- Education of patients, families and carers and activation of social supports, voluntary and non-voluntary agencies should follow diagnosis.
- Antipsychotics should be used with caution and use should be reviewed at regular intervals.
(Text taken from ICGP 2014 Quick Reference Guide Dementia: Diagnosis and Management in General Practice)