Detecting Dementia By Primary Health Care
If someone has signs of cognitive decline, it is important for them to see a specialist who can make a full diagnosis. Also, detecting dementia during a primary care visit may be the key to slowing the progression of the disease and the loss of autonomy.
In the case of cognitive decline, early detection can help slow progress significantly. As Pastor et al. (2003) argue, late diagnosis of dementia can affect the quality of life of patients and their families.
On the other hand, symptoms observed by a doctor during a primary care visit may be due to a temporary condition. Therefore, a thorough differential diagnosis is very important.
Why is early detection so important?
On the other hand, early diagnosis can make it easy to identify the causes of the disease. If the patient suffers from some type of reversible dementia, they would have time to get the right treatment.
It also facilitates the introduction of pharmacological and behavioral measures, which have been shown to be effective in preserving cognitive function.
Also, early detection of dementia can give the family the chance to get used to the news little by little. It can be difficult for families to cope with the changes dementia brings, so having time to process the information can potentially reduce stress.
Warning Signs
Arenillas et al. (2018) divided the warning signs of dementia into three categories: cognitive, behavioral, psychological and functional. The main cognitive signs useful for detecting dementia are the following:
- difficulty remembering recent events, routes, or names, forgetting messages, or
- repeating the same question over and over
- difficulty adapting to change
- trouble finding the right words
- greater difficulty in performing tasks and activities that require organization and planning
The main behavioral or psychological symptoms that make detecting dementia easier during primary care visits are:
- personality and mood changes
- apathy
- lack of motivation and initiative
- behavioral changes
- psychiatric symptoms in people with no history of psychiatric problems
The main functional symptoms are:
- trouble completing normal tasks at home, at work, or during free time
- neglecting personal hygiene and self-care
- withdrawal from work or social activities
- problems managing money
Assessment and detection of dementia during primary care visits
The first medical professional to see someone with signs of cognitive decline is their primary care physician. The first thing doctors do when they see a new patient is to examine their medical history.
In other words, they “question” the patient and the individuals with them to learn about their symptoms and previous illnesses and treatments. During this interview, the doctor systematically collects data for a patient’s pathography (Redondo V.2017).
For example, the medical history includes when and how the disease started, how the patient thinks it developed, and whether they have noticed any personality and/or behavioral changes. The result of this first study is the making of a diagnostic hypothesis.
Protocol for Dementia Detection During Primary Care Visits
The Guide Keys for Early Detection and Intervention or Demen Reception in Primary Care [translation] . Pastor, et al a doctor should do the following:
- Collect personal and family medical histories, specifically related to neurological pathology, vascular infections, and traumatic brain injuries, as well as psychiatric pathologies, comorbidities, and prescription drug use.
- Do a complete physical exam.
- Take all important additional tests. Take analytical tests, MRI scans, cognitive screening tools, and functional and neuropsychiatric evaluations.
In addition, once the physician has done all of the above, he or she should also write out necessary referrals to neuropsychological, psychiatric, and geriatric specialists.
The purpose of the referral is to confirm the diagnosis of dementia and to find out what type of dementia the patient is suffering from. The specialists will also be able to do the appropriate tests to put the patient on the right path to the appropriate treatment as quickly as possible.
In short, holistic and personalized care is essential for a proper diagnosis of a disease. That is why multidisciplinary and interdisciplinary work is so important, especially in situations that can change a person’s life so drastically.
