General practitioner's knowledge, attitudes, and difficulties in managing patients with dementia in primary health settings.

Abstract

Dementia is a global public health problem. The level of overall management of dementia by general practitioners (GPs) is unclear. This study mainly assessed the level of prevention, diagnosis, treatment, and attitudes of GPs toward dementia. An online questionnaire survey was sent to the wechat group from January 2021 to July 2023. A total of 120 GPs were recruited from community GPs. Data on general demographic characteristics and the preventive, diagnostic, therapeutic, and screening knowledge for dementia were collected. The percentages of correct answers were 86.67% for overall symptoms, 30.83% for specific symptoms, 39.17% for etiology, 27.5% for diagnostic methods, 41.67% for treatment, and 55% for screening methods. Mental and behavioral symptoms were chosen by 95% respondents, cognitive impairment by 91.7%, and impaired ability of daily living by 90.8%. Regarding the specific symptoms of dementia, the highest chosen options were decreased recent memory (95%) and decreased judgment and calculation (93.3%) by all participants. Among the common causes, "degenerative diseases of the nervous system" was endorsed by the most respondents (95.8%). There was no significant difference in the knowledge level of dementia across GPs with different characteristics. The most chosen diagnostic method was medical history (95.8%), followed by dementia-related scale (91.7%) and cranial imaging examination (67.5%). 55% participants chose neuropsychological scale evaluation as the most important screening method. The percentages of participants who had the training needs of dementia knowledge were as follows: 95% for prevention of dementia, 92.5% for selection and application of dementia screening tools, 91.7% for general treatment of dementia, 90% for risk factors of dementia, 89.2% for care and social support strategies for dementia patients, and 88.3% for identification of predementia and early symptoms. Insufficient professional support (90%), lack of dementia-related knowledge (86.7%), insufficient cognition and concern of patients (85%), and lack of time for clinical consultations (75%) were the main barriers for GPs to manage dementia. GPs' knowledges of early detection, etiology, and risk factors for dementia, and treatment still need to be further strengthened. More trainings are needed to make GPs competent to manage long-term care of dementia patients.