Evaluation of early dementia by a trained nurse

Patients tend to get referred to psychogeriatricians late in the course of a dementing illness, often when a crisis has occurred and carers can no longer cope. Earlier referral is disirable, but generates extra work for the psychogeriatrician. Nurse screening may overcome this. In this study a nurse, trained in the administration of the CAMDEX structured interview and supervised by a psychogeriatrician, performed a diagnostic assessment on patients with early cognitive impairment referred from primary care. This initial phase of the study sought to validate the nurse's assessment, and found that in 33 patients with possible early cognitive impairment, there was good broad agreement between the nurse's diagnosis and a psychogeriatrician's diagnosis supported by standardized rating scales. Nurse screening may be a cost‐effective means for a secondary care psychogeriatric service to provide support to general practitioners, form a case register of patients with early dementia, and follow these patients through as their dementia progresses.