[Dementia in Belgium: prevalence in aged patients consulting in general practice]

Early detection of dementia is an important element for the efficacy of therapies currently proposed to slow down disease progression. This detection mainly relies on general practitioners. In order to estimate the impact of dementia on health services, we have estimated from the data of the NAtional Dementia Economic Study (NADES) the prevalence rate of dementia in patients aged > or = 65 years living at home and consulting in general practice. The study population was based on the sampling of consecutive patients consulting a general practitioner, irrespective of the reason and location of the consultation. The diagnosis of dementia was based on the CAMDEX performed at home in patients presenting > or = 3 warning signs of dementia. The prevalence rate of dementia among 2.234 registered patients living at home was 14.3% (CI95: 12.6-16.0). In age groups 65-74, 75-84 and > or = 85 years, it was 7.0%, 17.5% and 18.5%, respectively, in men, and 6.1%, 15.8% and 25.2%, respectively, in women. The percentage of demented with mild, mild to moderate, moderate and severe dementia was 35.0%, 38.8%, 13.1% and 13.1%, respectively. After adjusting for the age and sex distribution of the Belgian population, the prevalence rate in patients aged > or = 65 years was estimated at 11.3%. A diagnosis of dementia had already been made by a specialist in 41.5% of patients with dementia, with figures of 19.3%, 34.3%, 41.9% and 60.9% according to the severity of disease (mild, mild to moderate, moderate, severe). The onset of first symptoms had preceded the diagnosis by an average of 1 year. Our results show a high prevalence rate of dementia in the elderly living at home consulting in general practice, and less than half of the patients had previously been diagnosed. It is possible that a systematic detection will not be performed as long as specific treatments are not made widely available.