Using clinical judgement to diagnose dementia

In practice, GPs are unlikely to use clinical judgement as a single test, either to confirm or exclude mild to moderate dementia or cognitive impairment, but findings from this review indicate that clinical judgement is likely to be more specific than sensitive.

It would be necessary to use additional tests to confirm the diagnosis for either dementia or cognitive impairment, or to confirm the absence of these conditions, but clinical judgement may inform the choice of further testing.

Many people who a GP judges as having dementia will have the condition. People with false negative diagnoses are likely to have less severe disease, and some could be identified by more formal testing. Some false positives may require similar practical support to those with dementia, but some – for example, people with depression – may potentially experience delayed intervention for an alternative treatable pathology.