Education And Debate

North of England evidence based guidelines development project: guideline for the primary care management of dementia

BMJ 1998; 317 doi: http://dx.doi.org/10.1136/bmj.317.7161.802 (Published 19 September 1998) Cite this as: BMJ 1998;317:802
  1. Martin Eccles (Martin.Eccles@ncl.ac.uk), professora,
  2. Julie Clarke, general practitionerb,
  3. Moira Livingston, consultantc,
  4. Nick Freemantle, senior research fellowd,
  5. James Mason, research fellowd,
  6. for the North of England Evidence Based Dementia Guideline Development Group
  1. aCentre for Health Services Research, University of Newcastle upon Tyne, Newcastle upon Tyne NE2 4AA
  2. bDepartment of Primary Health Care, School of Health Sciences, Medical School, Newcastle upon Tyne NE2 4HH
  3. cPsychiatry of Old Age Service, North Tyneside General Hospital, North Shields NE29 8NH
  4. dCentre for Health Economics, University of York, York YO1 5DD
  1. Correspondence to: Professor Eccles
  • Accepted 23 April 1998

Other members of the guideline development and project groups are listed at the end of the paper.

This guideline aims to provide recommendations to assist general practitioners manage people with all forms of dementia and help their carers. This is a summary version of the full guideline.1 The areas covered were developed in conjunction with the guideline development group. They were felt to reflect areas that were important in daily clinical practice. The guideline is for the management of patients with dementia; although it covers the area of screening instruments, it is not meant to cover the area of differential diagnosis. All recommendations are for general practitioners and apply to patients attending general practice with dementia. The development group assumes that doctors will use their knowledge and judgment in applying the principles and recommendations given below in managing individual patients, since the recommendations may not be appropriate for all circumstances. Doctors must decide to adopt any particular recommendation in the light of available resources and the circumstances of individual patients. Throughout this guideline categories of evidence (cited as I, II, or III) and the strength of recommendations (A, B, C, or D) are as described in previous method papers and the full version of the guideline. 1 2 A summary of categories of evidence and strength of recommendations is given in the box.

Summary points

In general practice, dementia has an incidence of 1.6, a prevalence of 3.6, and a workload of 7.4 consultations per year

General practitioners should use formal cognitive testing as well as clinical judgment in diagnosing dementia

The impact of caring depends on factors such as behaviour and affect more than on the severity of the cognitive impairment

Search strategy and synthesis

The search strategy was carried out using Medline (covering 1966-96), BIDS-EMBASE(1980-96), and PsycLIT (1974-96). Searches were limited to English …

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