Dementia diagnosis and management: a narrative review of changing practice

Through the EVIDEM project, Professor Steve Iliffe and colleagues, reviewed studies of interventions to improve GPs performance in the early detection and management of dementia. Interventions proved more successful when tailored to the learning needs of the GPs and developed with them.

Publications up to February 2010 were identified by searching the electronic databases MEDLINE, Embase, and PsycINFO, and bibliographies. The criterion for inclusion was that studies had to be of interventions aimed at improving detection or management of dementia in primary care. Exclusion criteria included studies in non-English publications, pharmacological interventions, and screening instrument studies. Quality was assessed using the PEDro (Physiotherapy Evidence Database) scale.

The quality of the studies varied considerably. Educational interventions are effective when learners are able to set their own educational agenda. Although modifying the service pathway and using case management can assist in several aspects of dementia care, these would require the provision of extra resources, and their value is yet to be tested in different health systems.

Iliffe S., Koch T, Dementia Diagnosis and management: a narrative review of changing practice. British Journal of General Practice 2011; Aug: 513-525.