ArticleBJGP open2021
Clinical judgment of GPs for the diagnosis of dementia: a diagnostic test accuracy study.
Article in BJGP open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.
- Clinical judgement by primary care physicians for the diagnosis of all-cause dementia or cognitive impairment in symptomatic people.The Cochrane database of systematic reviews · 2022Pooled it
- The Montreal Cognitive Assessment at the Framingham Heart Study: A Re-Examination of the Norms.Brain and behavior · 2026Article
- Diagnosis patterns among diverse populations with mild cognitive impairment and Alzheimer's disease in the USA.JAR life · 2026Article
- Variation in dementia screening outcomes: the influence of primary care providers' occupations and knowledge, attitudes, skills.BMC primary care · 2025Article
- Incidence and prevalence of dementia among US Medicare beneficiaries, 2015-21: population based study.BMJ (Clinical research ed.) · 2025Article
- Informant accuracy of IQCODE, AD8 and GPCOGi for diagnosis of dementia: does your friend know best?BMC primary care · 2025Article
- Estimating the incidence of dementia in New Zealand: a cohort study applying capture-recapture modelling to routinely collected linked health datasets.The Lancet regional health. Western Pacific · 2024Article
- The use of the integrated cognitive assessment to improve the efficiency of primary care referrals to memory services in the accelerating dementia pathway technologies study.Frontiers in aging neuroscience · 2023Article
- A Diagnostic Test Accuracy Study Investigating General Practitioner Clinical Impression and Brief Cognitive Assessments for Dementia in Primary Care, Compared to Specialized Assessment.Journal of Alzheimer's disease : JAD · 2023Article
- Patterns of unplanned hospital admissions among people with dementia: from diagnosis to the end of life.Age and ageing · 2022Article
Corrections and comments
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Authors and funding
7 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundGPs often report using clinical judgment to diagnose dementia.
aimTo investigate the accuracy of GPs' clinical judgment for the diagnosis of dementia. DESIGN &
settingDiagnostic test accuracy study, recruiting from 21 practices around Bristol, UK.
methodThe clinical judgment of the treating GP (index test) was based on the information immediately available at their initial consultation with a person aged ≥70 years who had cognitive symptoms. The reference standard was an assessment by a specialist clinician, based on a standardised clinical examination and made according to the 10th revision of the International Classification of Diseases (ICD-10) criteria for dementia.
resultsA total of 240 people were recruited, with a median age of 80 years (interquartile range [IQR] 75-84 years), of whom 126 (53%) were men and 132 (55%) had dementia. The median duration of symptoms was 24 months (IQR 12-36 months) and the median Addenbrooke's Cognitive Examination III (ACE-III) score was 75 (IQR 65-87). GP clinical judgment had sensitivity 56% (95% confidence interval [CI] = 47% to 65%) and specificity 89% (95% CI = 81% to 94%). Positive likelihood ratio was higher in people aged 70-79 years (6.5, 95% CI = 2.9 to 15) compared with people aged ≥80 years (3.6, 95% CI = 1.7 to 7.6), and in women (10.4, 95% CI = 3.4 to 31.7) compared with men (3.2, 95% CI = 1.7 to 6.2), whereas the negative likelihood ratio was similar in all groups.
conclusionA GP clinical judgment of dementia is specific, but confirmatory testing is needed to exclude dementia in symptomatic people whom GPs judge as not having dementia.
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