Diagnostic evaluation of the mentally impaired elderly living at home

Of 334 elderly persons aged 75 years and over, drawn from a random sample living at home, 38 were diagnosed as mentally impaired by a GP during an examination in the respondent's home. The GP also made diagnoses as to the cause of the mental impairment. These diagnoses agreed in 79% of cases with the final diagnoses after psychogeriatric assessment, including cerebral CAT-scan, EEG, and ECG investigation. The GP's diagnosis was changed in 8 cases; in 5 primarily due to the findings on the cerebral CAT-scan, and in 3 to the psychogeriatric assessment. The study showed that a GP with some experience in geriatric medicine was able to arrive at a correct clinical diagnosis regarding the cause of acquired mental impairment in elderly people in about 3/4 of the cases. A programme for the GP's diagnostic evaluation of the mentally impaired elderly is outlined.