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Clinical judgement of general practitioners: an effective tool in the diagnosis of dementia?

Part of: BJPsych Advances Cochrane Corner and Round the Corner Collection

Published online by Cambridge University Press:  20 September 2023

Aditi Rajgopal Open the ORCID record for Aditi Rajgopal [Opens in a new window]  and
Gracy Singh
Aditi Rajgopal*
Affiliation:
Foundation Year 2 doctor with an interest in primary care who is currently working in Buckinghamshire Healthcare NHS Hospital Trust, at Stoke Mandeville Hospital, Aylesbury, UK.
Gracy Singh
Affiliation:
Foundation Year 2 doctor with an interest in global mental health, currently working in Buckinghamshire Healthcare NHS Hospital Trust, at Stoke Mandeville Hospital, Aylesbury, UK.
*
Correspondence Aditi Rajgopal. Email: aditi.rajgopal1@nhs.net
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Summary

The diagnosis of dementia poses several challenges, as a consequence of which the condition has been widely reported to be underdiagnosed in the general population. Currently, there is no single diagnostic test for dementia and the clinical judgement of primary care physicians is therefore a key determinant in identifying which patients are referred to specialist services for further assessment. This month's Cochrane Corner review found that the clinical judgement of general practitioners is more specific (58–99%) than sensitive (34–91%) in diagnosing dementia, although the data were limited by small sample size and significant heterogeneity. This commentary provides a critical appraisal of this systematic review and attempts to extrapolate conclusions relevant to current clinical practice, including potential areas of further research, to facilitate appropriate and timely referral of patients with suspected dementia to specialist services.

Keywords

Dementiaprimary caregeneral practitionerclinical judgementdiagnosis
Type
Round the corner
Information
BJPsych Advances , Volume 29 , Issue 6 , November 2023 , pp. 369 - 372
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Copyright
Copyright © The Author(s), 2023. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists

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Footnotes

Commentary on… Clinical judgement by primary care physicians for the diagnosis of all-cause dementia or cognitive impairment in symptomatic people (Cochrane Corner). See this issue.

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