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Open Access Highly Accessed Correspondence

Diagnosing dementia: No easy job

Frank Buntinx12*, Jan De Lepeleire1, Louis Paquay13, Steve Iliffe4 and Birgitte Schoenmakers1

Author Affiliations

1 Katholieke Universiteit Leuven, Department of General Practice, Kapucijnenvoer 33, blok J, B 3000, Leuven, Belgium

2 Maastricht University, Department of General Practice, PO box 616, Nl 6200 MD Maastricht (the Netherlands

3 Wit-gele Kruis van Belgie, Ad. Lacomblélaan 69, 1030 Brussels, Belgium

4 University College London, Department of Primary Care & Population Health, Royal Free Campus, Rowland Hill St., London NW3 2PF UK

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BMC Family Practice 2011, 12:60  doi:10.1186/1471-2296-12-60

Published: 27 June 2011



From both clinical experience and research we learned that in complex progressive disorders such as dementia, diagnosis includes multiple steps, each with their own clinical and research characteristics.


Diagnosing starts with a trigger phase in which the GP gradually realizes that dementia may be emerging. This is followed by a disease-oriented diagnosis and subsequently a care -oriented diagnosis. In parallel the GP should consider the consequences of this process for the caregiver and the interaction between both. As soon as a comprehensive diagnosis and care plan are available, monitoring follows.


We propose to split the diagnostic process into four diagnostic steps, followed by a monitoring phase. We recommend to include these steps when designing studies on screening, diagnosis and monitoring of patients with dementia and their families.