EVALUATION OF EARLY DEMENTIA BY A TRAINED NURSE

Patients tend to get referred to psychogeriatricians late in the cours e of a dementing illness, often when a crisis has occurred and carers can no longer cope. Earlier referral is desirable, but generates extra work for the psychogeriatrician. Nurse screening may overcome this. I n this study a nurse, trained in the administration of the CAMDEX stru ctured interview and supervised by a psychogeriatrician, performed a d iagnostic assessment on patients with early cognitive impairment refer red from primary care. This initial phase of the study sought to valid ate the nurse's assessment, and found that in 33 patients with possibl e early cognitive impairment, there was good broad agreement between t he nurse's diagnosis and a psychogeriatrician's diagnosis supported by standardized rating scales. Nurse screening may be a cost-effective m eans for a secondary care psychogeriatric service to provide support t o general practitioners, form a case register of patients with early d ementia, and follow these patients through as their dementia progresse s.