Dementia: opportunities for risk reduction and early detection in general practice.

This project aimed to measure general practitioner (GP), practice nurse and patient health literacy about memory problems, dementia and its risk factors. Data were collected from general practices across Australia and a smaller sample in England. Questionnaires explored sources and adequacy of dementia knowledge and a randomised controlled trial tested the intervention of a dementia risk reduction pamphlet on patient knowledge of dementia risk reduction strategies. Data were analysed using SPSS software. The results of 621 questionnaires from patients aged over 30 years showed 37% had memory concerns, 6% recalled having a memory test, 52% would like a memory test and 15% had heard about dementia from their GP. Patients receiving the intervention were significantly more likely to be aware of dementia risk reduction strategies (P≤0.005). The results of 153 GP/nurse questionnaires indicated 64% thought a doctor should discuss dementia with patients despite only 21% assessing their dementia knowledge as adequate. There was no significant difference in responses between Australia and England (P≥0.05). The frequency of documentation of Mini-Mental State Examination and dementia diagnosis in computerised medical records of patients over 75 years was less than 0.01. These results demonstrate that many adult patients attending GPs have memory concerns, associate dementia with memory loss, and are receptive to information about dementia risk reduction. Most general practitioners and their nurses rate their dementia knowledge as inadequate with few testing for memory problems or discussing dementia with their patients.