FC33: Attitudes of Primary Care Physicians towards Cognitive Impairment-Dementia. A survey in Galicia, Spain

Abstract

Introduction and Objectives: Cognitive impairment-dementia is an increasing health concern with a major economic and social impact. This study aims to examine how it is currently approached in primary care practices in the Autonomous Community of Galicia, Spain.

Methods: A working group was formed between two scientific societies, which developed a survey that was sent online to 2206 primary care doctors, subsequently analysing the responses received.

Results: A total of 124 primary care doctors (5.3%) responded to the survey, 69.4% of which were women, with a mean age of 54 years. Out of these doctors, 92 (80%) have been working for more than 10 years, 30 (24.2%) have never received any training on the topic of study and only 31 (25%) have received some training in the last 5 years. The initial complaint derives from close relatives (76.6%) and this complaint usually entails memory problems (59.7%). The screening test used by 77.4% of the professionals is the MMSE with a higher prevalence among younger doctors (p-value 0.04). In the case of suspected cognitive impairment, doctors perform a cognitive assessment scale (96%), order a blood test (83.9%) and perform functional assessment scales (77.4%). They do so on a scheduled basis (79%). In total, 42.7% recognise that they reach the diagnosis in moderate dementia stages, hindered as a result of care-based reasons (66.9%). Doctors have difficulties in detecting the pathology associated with cognitive impairment in 52.4% of cases. In dementia management, 66.1% have difficulties in providing caregiver support and 42.7% with pharmacological treatment. In cases of advanced dementia, the problem is the lack of support from social services (47.6%), hospital specialists (45.2%) and the difficulty of pharmacological treatment (43.5%).

Conclusions: Primary care doctors report that the main barriers in the care for cognitive impairment-dementia are: training, healthcare organization, social, management of specific dementia treatments and associated pathologies and coordination with hospital care.

Key words: Primary care, cognitive impairment, dementia, screening, survey, attitudes