[The general practitioner faced with memory problems in the aged patient in Luxembourg: a study of the management employed, the experience of the physicians and the perception of the specific treatment]
Université Pierre et Marie Curie, Paris 6.Bulletin de la Société des sciences médicales du Grand-Duché de Luxembourg 07/2012;
Memory impairments are common in elderly. General practitioners are in first line to detect and manage these troubles, for which many countries published recommendations. For Alzheimer disease there are currently four treatments, none of which is healing. Some countries limited the first prescription of those medicines to specialists whereas in Luxembourg, every practitioner is allowed to prescribe them, but has to ask health insurance first. Consequently, it is important that general practitioners know what to do. The aim of our paper is to study the management done by the general practitioners in Luxembourg, the way they feel about it and the way they see the specific medicines for Alzheimer disease. Therefore, we have sent a questionnaire to every general practitioner in Luxembourg. We found that 87% of the practitioners realize at least one cognitive impairment test. More than half of them check for depression and 22.6% also add an autonomy assessment scale, even though all these tests are done by the dependence insurance. The involvement of general practitioners in the diagnosis of dementia is important as more than half of them have a statistically adequate number of demented patients. About two third of the practitioners do systematically start a specific medicine for Alzheimer disease. The management of cognitive impairment is difficult for general practitioners of Luxembourg, particularly the disclosure of diagnosis and management of behavioural and psychological symptoms.
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