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GPs could diagnose dementia ‘with three simple questions’

GPs could use a set of simple questions instead of more time-consuming standard questionnaires to diagnose dementia in elderly men, researchers have claimed.

In a study of over 200 men, the team found that simple questions put to someone who knew the patient well were more useful for ruling in a diagnosis of dementia and than the mini-mental state examination.

Three questions in particular showed over 90% accuracy and 100% specificity when added to clinical findings, relative to a specialist diagnosis. These were, compared with 10 years ago:

  • How is this person at handling financial matters e.g. the pension, dealing with the bank?
  • How is this person at using his/her intelligence to understand what’s going on and to reason things through?
  • Does this person have greater difficulty thinking and planning ahead?

Although the sensitivity of the tests was relatively low, the study authors noted that given Government policy encourages GPs to diagnose dementia in primary care, ‘avoiding over-diagnosis (high specificity) may be more important than finding all possible cases (high sensitivity)’.

The team concluded: ‘This study found that three simple questions have high utility for diagnosing dementia in men who are cognitively screened. If confirmed, this could lead to less burdensome assessment where clinical assessment suggests possible dementia.’

Br J Gen Pr 2015; available online 6 August