GPs and primary health care teams need to be alert to the signs and symptoms of dementia, including those conditions in which dementia may occur:
- Huntingdon’s Disease;
- Parkinson’s Disease;
- cardiovascular disease, including stroke
- depression
Memory problems
- When people present with memory problems, they should be screened for dementia by undertaking an initial clinical assessment to exclude other causes.
- GPs may choose to refer to a specialist memory assessment service where early dementia is suspected, and/or a differential diagnosis is being sought.
- See initial assessment and routine investigations below
- Access Cognitive Assessment Tools
- View the Dementia assessment care map
- Go to the Dementia assessment care map online (External link)
- View the Dementia management care map
- Go to the Dementia management care map online (External link)
- View local protocol – referral to memory services
Primary care: initial assessment
When patients present with memory problems, in order to exclude reversible or physical causes of presenting symptoms, GPs should undertake,
- a clinical assessment, including history, examination and investigations,
- an assessment for depression, anxiety and other mental health problems;
- all patients should be offered blood screening for full blood count, calcium, glucose, renal and liver function tests, serum vitamin B12 and folate levels. This should be recorded in primary care notes.
| Quality and Outcomes Framework for GMS contract 2011/12, DEM 3 | ||||
| No. | Indicator | Points | Payment stages | |
| DEM3 | The percentage of patients with a new diagnosis of dementia from 1 April 2011 to have FBC, calcium, glucose, renal and liver function, thyroid function tests, serum vitamin B12 and folate levels recorded 6 months before or after entering on to the register | 6 | 40-80% | |
- View the dementia section from the Quality and Outcomes Framework guidance for GMS contract 2011/12
- View Quality and Outcomes Framework guidance for GMS contract 2011/12
Making a diagnosis
GPs may diagnose dementia where it is clear that the condition is already established. This may include patients at the more advanced stages of the disease, at home or in care homes. (South West Dementia Partnership, 2011)
- View standards for diagnosing dementia
- View Guidelines on the Prescribing of Antipsychotics for People with Dementia
- View a local shared care protocol: prescribing of antipsychotics for people with dementia
Dementia Register
Primary health care teams should know who has a diagnosis of dementia, and maintain a general practice Dementia Register (QOF DEM 1).
| Quality and Outcomes Framework for GMS contract 2011/12, DEM 1 | ||||
| No. | Indicator | Points | Payment stages | |
| DEM1 | The practice can produce a register of patients diagnosed with dementia | 5 | ||
- View the dementia section from the Quality and Outcomes Framework guidance for GMS contract 2011/12
- View Quality and Outcomes Framework guidance for GMS contract 2011/12
- Go to 10 Steps to improving rates of diagnosis
- Go to Case Finding
References
- South West Dementia Partnership (2011) Diagnosing Dementia Guidance and Standards
