چکیده (انگلیسی):

Background:People with cognitive problems, and their families, report distress and uncertainty whilst undergoing
evaluation for dementia and perceive that traditional diagnostic evaluation in secondary care is insufficiently patient
centred. The James Lind Alliance has prioritised research to investigate the role of primary care in supporting a
more effective diagnostic pathway, and the topic is also of interest to health commissioners. However, there are
very few studies that investigate the accuracy of diagnostic tests for dementia in primary care.
Methods:We will conduct a prospective diagnostic test accuracy study to evaluate the accuracy of a range of simple
tests for diagnosing all-cause-dementia in symptomatic people aged over 70 years who have consulted with their
general practitioner (GP). We will invite eligible people to attend a research clinic where they will undergo a range of
index tests that a GP could perform in the surgery and also be assessed by a specialist in memory disorders at the
same appointment. Participating GPs will request neuroimaging and blood tests and otherwise manage patients in line
with their usual clinical practice. The reference standard will be the consensus judgement of three experts (neurologist,
psychiatrist and geriatrician) based on information from the specialist assessment, GP records and investigations, but
not including items in the index test battery. The target condition will be all-cause dementia but we will also
investigate diagnostic accuracy for sub-types where possible. We will use qualitative interviews with patients
and focus groups with clinicians to help us understand the acceptability and feasibility of diagnosing dementia in
primary care using the tests that we are investigating.
Discussion:Our results will help clinicians decide on which tests to perform in someone where there is concern about
possible dementia and inform commissioning of diagnostic pathways.