Dementia Approach and Follow-up in Primary Care

Authors

  • Ana Jorge Oliveira Lopes USF Viriato - ACES Dão Lafões Viseu
  • Vitor Martins USF Viriato - ACES Dão Lafões Viseu
  • João Ribeiro USF Viriato - ACES Dão Lafões Viseu

DOI:

https://doi.org/10.29352/mill0203.04.00114

Keywords:

Dementia, family physician, caregiver

Abstract

Introduction: The prevalence of dementia has been increasing in recent years in parallel with an ageing population. Today it is a common pathology in primary care level.

Objectives: To review the family physician’s role in diagnosing and following up on patients with dementia.

Methods: Theoretical review based on researching clinical guidelines, systematic and original articles published in English and Portuguese in PubMed, Clinical Key, UpToDate, the Index of Portuguese Journals from January 2006 to September 2016 using the MeSH terms: “Dementia,” “Primary Health Care,” “Primary Care Nursing” and “Primary Care Physician.”

Results: When dementia is suspected, it is important to resort to family members and/or caregivers’ cooperation, to conduct a thorough medical history of the patient, focusing on behavioural and cognitive symptoms and changes in daily activities. Subsequently, an objective examination should be carried out and an array of cognitive, psycho-affective and functional assessment tests applied. Finally, an analytical and imaging evaluation should be performed. Equally important is the role of the family physician in the patient’s subsequent treatment/guidance and support to families and caregivers in care management.
Conclusions: The family physician is in a prime position for early detection of dementia. Clinical diagnosis is essential and is not always easy at an early stage. The role of doctors and other professionals in primary health care should not be limited to the initial assessment, but should extend to following up on and guiding the sick and their respective families.

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Author Biographies

Ana Jorge Oliveira Lopes, USF Viriato - ACES Dão Lafões Viseu

Médico Interno

Vitor Martins, USF Viriato - ACES Dão Lafões Viseu

Médico Interno

João Ribeiro, USF Viriato - ACES Dão Lafões Viseu

Médico Assistente

References

Alves, R., & Caetano, A. (2010). O papel do Médico de Família no diagnóstico e seguimento dos doentes com declínio cognitivo e demência. Rev Port Clin Geral, 26(1), 69-74.

American Psychiatric Association (2014). DSM-5: Manual de Diagnóstico e Estatística das Perturbações Mentais (5ª ed.). Lisboa: Climepsi.

Boustani, M., Schubert, C., & Sennour, Y. (2007). The challenge of supporting care for dementia in primary care. Clinical Interventions in Aging, 2(4), 631-636.

Darrow, M. D. (2015). A practical approach to dementia in the outpatient primary care setting. Prim Care Clin Office Pract, 42(2), 195-204. doi:10.1016/j.pop.2015.01.008

Dodd, E., Cheston, R., & Ivanecka, A. (2015). The assessment of dementia in primary care. Journal of Psychiatric and Mental Health Nursing, 22, 731-737.

Galvin, J. E., & Sadowsky, C. H. (2012). Practical guidelines for the recognition and diagnosis of dementia. J Am Board Fam Med, 25, 367-382. doi: 10.3122/jabfm.2012.03.100181

Holzer, S., Warner, J., & Iliffe, S. (2013). Diagnosis and management of the patient with suspected dementia in primary care. Drugs Aging, 30(9), 667-76. doi: 10.1007/s40266-013-0098-4

Larson, E.B. (2016). Evaluation of cognitive impairment and dementia. Obtido de www.uptodate.com

Norma da Direção Geral da Saúde, Nº 053/2011, Abordagem Terapêutica das Alterações Cognitivas. Obtido de https://www.dgs.pt/directrizes-da-dgs/normas-e-circulares-normativas/norma-n-0532011-de-27122011.aspx

Pinho, L. F. (2008). Demência: A marcha diagnóstica no âmbito dos Cuidados de Saúde Primários (Dissertação de Mestrado em Medicina). Faculdade de Ciências da Saúde da Universidade da Beira Interior, Covilhã.

Poggesi, A., & Pantoni, L. (2009). Investigations in primary care. Front Neurol Neurosc, 24, 66-78. doi: 10.1159/000197885

Pond, D. (2012). Dementia an update on management. Australian Family Physician, 41(12), 936-939.

Rodrigues, A. P., Sousa-Uva, M., Galvão, C., Nunes, B., & Dias, C. M. (2014). Prevalência de demências na população sob observação da Rede de Médicos-Sentinela em 2006. Boletim epidemiológico de observações, 3(10), 9-10.

Samsi, K., & Manthorpe, J. (2014). Care pathways for dementia: Current perspectives. Clinical Interventions in Aging, 9, 2055-2063.

Santana, I., Farinha, F., Freitas, S., Rodrigues, V., & Carvalho, A. (2015). Epidemiologia da demência e da doença de Alzheimer em Portugal: Estimativas da prevalência e dos encargos financeiros com a medicação. Acta Med Port, 28(2), 182-188.

Souza, L. C., Sarazin, M., Goetz, C., & Dubois, B. (2009). Clinical investigations in primary care. Front Neurol Neurosci, 24, 1-11. doi: 10.1159/000197897

Nunes, B., Silva, R. D., Cruz, V. T., Roriz, J. M., Pais, J., Silva, M. C. (2010). Research article Prevalence and pattern of cognitive impairment in rural and urban populations from Northern Portugal. BMC Neurology, 10(42), 1-12. doi: 10.1186/1471-2377-10-42

Published

2017-05-31

How to Cite

Lopes, A. J. O., Martins, V., & Ribeiro, J. (2017). Dementia Approach and Follow-up in Primary Care. Millenium - Journal of Education, Technologies, and Health, 2(3), 37–44. https://doi.org/10.29352/mill0203.04.00114

Issue

Section

Life and Healthcare Sciences