Early recognition or screening of dementia in general practice

General practitioners play a key role in timely dementia diagnosis. In view that there are currently no drugs to prevent the progression of dementia or are effective in patients with mild cognitive impairment, a general screening of older people to recognize pre-symptomatic stages of dementia is not recommended. Crucial for a timely diagnosis is the GP's perception of warning signs, so-called "red flags". If the patients, family members, authorities or even the GP notice even discreet signs of a possible early dementia, a neuropsychological and medical evaluation should be initiated. Personal history, history by informant, a physical examination, supplemented by a GP's psychiatric evaluation and ideally the careful assessment with the MoCA form the basis of a preliminary clarification in general practice. If dementia is suspected, this clarification should be supplemented by an in-depth laboratory examination and, if applicable, neuroimaging before the patient is referred, depending on the findings, to a memory clinic or a consultant specialist to confirm the diagnosis and if appropriate initiate pharmacological and non-pharmacological therapies.