RT Journal Article SR Electronic T1 Dementia in general practice: the practical consequences of a more positive approach to diagnosis. JF British Journal of General Practice JO Br J Gen Pract FD British Journal of General Practice SP 185 OP 188 VO 43 IS 370 A1 D W O'Connor A1 A Fertig A1 M J Grande A1 J B Hyde A1 J R Perry A1 M O Roland A1 J D Silverman A1 S K Wraight YR 1993 UL http://bjgp.org/content/43/370/185.abstract AB General practitioners are often reluctant to administer brief cognitive tests, and to question the relatives of patients who appear to be demented, for fear of causing distress. Diagnoses of dementia are therefore often based on guesswork, and non-demented patients may be rated as cognitively impaired in error. A randomly selected sample of 174 general practice patients aged 80 years and over were asked to complete a simple test of orientation and information in order to assess the usefulness and acceptability of such a procedure. If patients scored 10 points or less out of 12, a relative or other knowledgeable informant was questioned about their changes in mental state and behaviour. Assessments proved acceptable to patients, relatives and doctors; diagnoses were revised in 29 cases; and practical initiatives were proposed in 15 cases. Open discussions with patients and their families proved innocuous and have much to commend them.