Training course of evaluation and management of dementia for primary care physicians

As the increases of aged people, the number of patients with dementia is dramatically increasing in Japan. Early intervention is effective to prevent progression of dementia, including Alzheimer's disease (AD). In Fukui Prefecture, Japan, the dementia prevention campaign was started in 2011. As the tool of easy screening of dementia, short questionnaire was selected by the Dementia Prevention Team in Fukui. The questionnaires were sent via mail to the people aged 65 years and older without nursing certification living in Fukui prefecture, Japan. The people who have at least one positive item of questions were advised to be seen by the doctors. However, the number of specialists of dementia, neurologists or psychiatrists is not enough to handle such people, in Fukui, Japan. So, training course of evaluation and management of dementia for primary care physicians was planned. Several lectures about dementia, including differential diagnosis, radiological findings, treatment, or management were performed in the morning. Management of the behavioral and psychological symptoms of dementia (BPSD) is also included. In the afternoon, the practice how to take the interview, or how to do Mini-Mental State Examination (MMSE), or how to do core neurological examination to the simulated patients of AD and dementia with lewy bodies (DLB) was performed. Simulated patients are Certified nurse of dementia. After finishing the training course, questionnaires were collected by the attendee. The attending primary care physicians are generally satisfied by the training course. Many of the attendee are interested in the evaluation and management of dementia. They started to do MMSE or core neurological examination by themselves. After the training course, many of patients who advised to be seen by the primary care physicians first by the results of short questionnaire were tentatively diagnosed as AD, DLB, vascular dementia, or frontotemporal dementia. If necessary, such patients were referred to specialists. Such patients were treated by primary care physicians themselves under the supervision of the specialists. Training course of evaluation and management of dementia is useful methods for the better understanding of dementia especially for the non-specialists.