DETERMINANTS OF THE JUDGMENT OF GENERAL-PRACTITIONERS ON DEMENTIA

The aim of this study was to determine whether the judgement of general practitioners (GPs) on dementia conforms to the international concept of dementia. In this cross-sectional study we related GPs' judgements on dementia to items of the DSM-III-R criteria for dementia, Thirty-six GPs participated in the study, as well as 3731 community-dwelling elderly subjects, Items of the criteria for dementia were measured independently of the GP judgement, using the Geriatric Mental State Schedule (GMS). The GPs' judgements were related to the three criteria: memory (odds ratio (OR) = 2.1 (95% CI: 1.8-2.4)), other cognitive functions (OR = 1.6 (95% CI: 1.3-1.9)) and daily functioning (OR = 1.5 (95% CI: 1.3-1.9)). At item level, several relevant items of the criteria were related to the GPs' judgements recall, time orientation, concentration and muddled thinking, In addition, three items of daily functioning demanding cognitive skills (dependency in travelling, using medication and handling finances) were related. The items related to the severity categories of the GPs' judgements reflected the process of progression in dementia. We concluded that GPs conform to the international concept of dementia in their judgement on the presence of dementia, as well as in their categorization of severity.