Diagnostic information in GP referral letters to a memory clinic: a retrospective cohort study
Background: Dementia diagnostics can often be performed in primary care, yet older people with memory complaints are frequently referred to memory clinics (MCs). Aim: To compare diagnostic information in GP referral letters of patients with and without an eventual dementia diagnosis. Design &...
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Royal College of General Practitioners
2025-04-01
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| Series: | BJGP Open |
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| Online Access: | https://bjgpopen.org/content/9/1/BJGPO.2024.0065 |
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| author | Demi Ronner Dorien Oostra Jurgen Claassen Edo Richard Marieke Perry |
| author_facet | Demi Ronner Dorien Oostra Jurgen Claassen Edo Richard Marieke Perry |
| author_sort | Demi Ronner |
| collection | DOAJ |
| description | Background: Dementia diagnostics can often be performed in primary care, yet older people with memory complaints are frequently referred to memory clinics (MCs). Aim: To compare diagnostic information in GP referral letters of patients with and without an eventual dementia diagnosis. Design & setting: Retrospective cohort study in a Dutch academic MC. Method: We collected electronic health record (EHR) data of consecutive patients aged ≥65 years referred by their GP between 2016 and 2020. EHR data included patient characteristics, diagnostic information in referral letters, ancillary investigations performed at the MC, and established diagnoses. We performed χ2 tests to compare groups. Results: Of 651 patients included, the average age was 78.0 years (standard deviation 6.8) and 348 (53.5%) were diagnosed with dementia. Most people with dementia were diagnosed without ancillary investigations (n = 235/348, 67.5%). In GP referral letters of people with dementia compared with people without dementia, a collateral history, any physical examination, a differential diagnosis including dementia, a Mini-Mental State Examination score, interference with daily functioning, and decline from previous levels of functioning were mentioned more often. Furthermore, the more diagnostic criteria mentioned in the referral letter, the more often dementia was diagnosed at the MC (no criteria: 35.4%; one criterion: 47.3%; two criteria: 53.4%; three criteria: 69.9%; and four or five criteria: 83.3%). Conclusion: GPs often correctly mention diagnostic information and dementia criteria in referral letters of people with dementia, and they are often diagnosed without ancillary investigations. This suggests that referral is often unnecessary, and GPs can be empowered to diagnose dementia themselves. |
| format | Article |
| id | doaj-art-30ea26e4c3004ee18b84f9f6ce2437e7 |
| institution | DOAJ |
| issn | 2398-3795 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Royal College of General Practitioners |
| record_format | Article |
| series | BJGP Open |
| spelling | doaj-art-30ea26e4c3004ee18b84f9f6ce2437e72025-08-20T03:14:09ZengRoyal College of General PractitionersBJGP Open2398-37952025-04-019110.3399/BJGPO.2024.0065Diagnostic information in GP referral letters to a memory clinic: a retrospective cohort studyDemi Ronner0https://orcid.org/0000-0002-5194-4138Dorien Oostra1https://orcid.org/0000-0003-2463-7690Jurgen Claassen2https://orcid.org/0000-0002-1778-8151Edo Richard3https://orcid.org/0000-0002-7250-3390Marieke Perry4https://orcid.org/0000-0003-0675-9678Department of Primary and Community Care, Radboud University Medical Center (UMC) Alzheimer Center, Radboud UMC, Nijmegen, NetherlandsDepartment of Geriatric Medicine, Donders Institute for Brain, Cognition and Behavior, Radboud UMC, Nijmegen, NetherlandsDepartment of Geriatric Medicine, Donders Institute for Brain, Cognition and Behavior, Radboud UMC, Nijmegen, NetherlandsDepartment of Neurology, Radboud UMC Alzheimer Center, Radboud UMC, Nijmegen, NetherlandsDepartment of Primary and Community Care, Radboud University Medical Center (UMC) Alzheimer Center, Radboud UMC, Nijmegen, NetherlandsBackground: Dementia diagnostics can often be performed in primary care, yet older people with memory complaints are frequently referred to memory clinics (MCs). Aim: To compare diagnostic information in GP referral letters of patients with and without an eventual dementia diagnosis. Design & setting: Retrospective cohort study in a Dutch academic MC. Method: We collected electronic health record (EHR) data of consecutive patients aged ≥65 years referred by their GP between 2016 and 2020. EHR data included patient characteristics, diagnostic information in referral letters, ancillary investigations performed at the MC, and established diagnoses. We performed χ2 tests to compare groups. Results: Of 651 patients included, the average age was 78.0 years (standard deviation 6.8) and 348 (53.5%) were diagnosed with dementia. Most people with dementia were diagnosed without ancillary investigations (n = 235/348, 67.5%). In GP referral letters of people with dementia compared with people without dementia, a collateral history, any physical examination, a differential diagnosis including dementia, a Mini-Mental State Examination score, interference with daily functioning, and decline from previous levels of functioning were mentioned more often. Furthermore, the more diagnostic criteria mentioned in the referral letter, the more often dementia was diagnosed at the MC (no criteria: 35.4%; one criterion: 47.3%; two criteria: 53.4%; three criteria: 69.9%; and four or five criteria: 83.3%). Conclusion: GPs often correctly mention diagnostic information and dementia criteria in referral letters of people with dementia, and they are often diagnosed without ancillary investigations. This suggests that referral is often unnecessary, and GPs can be empowered to diagnose dementia themselves.https://bjgpopen.org/content/9/1/BJGPO.2024.0065dementiadiagnosiscare of older peopleaged |
| spellingShingle | Demi Ronner Dorien Oostra Jurgen Claassen Edo Richard Marieke Perry Diagnostic information in GP referral letters to a memory clinic: a retrospective cohort study BJGP Open dementia diagnosis care of older people aged |
| title | Diagnostic information in GP referral letters to a memory clinic: a retrospective cohort study |
| title_full | Diagnostic information in GP referral letters to a memory clinic: a retrospective cohort study |
| title_fullStr | Diagnostic information in GP referral letters to a memory clinic: a retrospective cohort study |
| title_full_unstemmed | Diagnostic information in GP referral letters to a memory clinic: a retrospective cohort study |
| title_short | Diagnostic information in GP referral letters to a memory clinic: a retrospective cohort study |
| title_sort | diagnostic information in gp referral letters to a memory clinic a retrospective cohort study |
| topic | dementia diagnosis care of older people aged |
| url | https://bjgpopen.org/content/9/1/BJGPO.2024.0065 |
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