Geven huisartsen aan dementerende patiënten en hun verzorgers de juiste informatie? Een prospectief observationeel onderzoek

Background: Many professional carers are hesitant about confronting dementia patients with their diagnosis. We wanted to know how often the GP communicates his diagnosis to patients in whom he suspects dementia and how often he tells the patient's carers. In addition we investigated the frequency with which the diagnosis was correct and how often it was not. Method: We carried out a prospective observational study. We instructed 64 GPs to apply, during the period of the study, the NHG Standard for Dementia to all patients aged 55 and older in whom they first suspected dementia and to refer these patents to a multidisciplinary memory clinic which would serve as diagnostic reference. Both the GPs and the team at the memory clinic entered their findings on a previously drawn up standard form. Results: The GPs recorded a total of 107 possible cases of dementia, 82 of whom were accompanied by their carers. Subsequent assessment showed dementia in 69 persons, absent in 29 and unsure in 9 cases. In most cases the GP's diagnosis was correct; two patients were wrongly diagnosed who, according to the memory clinic, did not have dementia and two who were indeed suffering from the condition. The GPs passed on their diagnosis to 42% of the patients with probable dementia and to 74% of the carers. Generally they asked about the carers' experiences but gave targeted advice in less than half the cases. Only when the dementia was relatively serious were the GPs somewhat more communicative, but were far more reluctant to pass on their diagnosis to the patients than to their carers. Conclusion: This study clearly shows that GPs ate ambivalent in their approach to patients with early signs of dementia and to their carers. They often leave the patients in ignorance but generally inform the carers.