. 2011 Feb 19;43(7):377–384. [Article in Spanish] doi: 10.1016/j.aprim.2010.09.004
© 2010 Elsevier Espa˜na, S.L. Todos los derechos reservados. Can dementia be diagnosed in primary care? Abstract Despite the personal and social value of an early diagnosis, more than 50% of demen- tias remain undetected. The author shares the view that primary care is an adequate setting for both the detection and diagnosis of dementia. This diagnosis is conducted through cli- nical interview, physical examination and mental status examination. Once confusional and focal neurobehavioral syndromes have been ruled out, it is useful to differentiate between subjective cognitive complaints, mild cognitive impairment (MCI) and dementia. The target syndrome should be MCI, since more than 50% of these patients develop dementia. In both MCI and dementia an objective and persistent cognitive impairment is detected that, in case of dementia, precludes some of the usual activities. Along with diagnosis, a global plan of care ought to be outlined. This plan should contemplate the prevention of accidents, the manage- ment of behavioural and psychological symptoms, the specific pharmacological treatment and caregiver support. © 2010 Elsevier Espa˜na, S.L. All rights reserved.
Figura 2.
Modelo jerárquico de interrelación entre el nivel de alerta, la afectividad, la conducta y las funciones cognitivas.
A: área; F: funciones.