# Algebra Some Current Trends by Avramov L.L. (ed.), Tchakerian K.B. (ed.)

By Avramov L.L. (ed.), Tchakerian K.B. (ed.)

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Nor is it surprising that the majority of general practitioners in the UK (Ineichen 1994) and a large minority of family physicians in the USA (Fortinsky and Wasson 1997) report no use of cognitive function tests in making a diagnosis of dementia. Nevertheless we believe that using a cognitive function test – any of the ones we have described will do – when dementia is a possibility can be a useful in gaining a whole picture of the individual, and should become standard practice in primary care.

Assessment, care planning and care management For the individual with dementia, and for those around them, the everyday tasks of life are more important than any score on a cognitive function test. Identifying problems in these abilities, problems in the coping strategies and helping the person with dementia and their family to address and plan for them is vital. The GP working with the patient and the family may be the first to share the diagnosis with them, and it may be obvious that they meet the eligibility criteria of the local authority for a full com­ prehensive assessment under the Community Care Act to prevent a breakdown in their present arrangements for care and support.

35 36 PRIMARY CARE AND DEMENTIA THE DIAGNOSTIC PROCESS Early identification of dementia can be important for forward planning of care, for education of patients, families and profes­ sional teams, and for mobilization of resources. Also, recent ther­ apeutic advances have renewed calls to improve detection and management of people with dementia because of some evidence of therapeutic benefit from selective use of the newer antidementia drugs. Even the earlier preparations like Tacrine (which is too toxic to be widely used) could be cost-neutral and save on nursing home placements, if used selectively and care­ fully by experienced clinicians.