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Subjective memory complaints in general practice predicts future dementia: a 4-year follow-up study
- Authors:
- WALDORFF Frans Boch, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 27(11), November 2012, pp.1180-1188.
- Publisher:
- Wiley
While many older patients have memory complaints (SMC), not all share this information with their GP. The association between SMC and future cognitive decline or dementia is not clear. This study determined the risk for receiving a subsequent hospital-based dementia diagnosis on the basis of patients' reports of SMC in a primary care setting. A total of 40,865 patients were listed with 24 GPs working in the inner district of Copenhagen municipality, Denmark, and 2,934 were 65 years or older. A total of 758 non-nursing home residents aged 65 years and older consulted their GP in October and November 2002, and, when asked, 24% reported memory problems, and 6.6% received a hospital-based dementia diagnosis within the 4-years follow-up. This study indicates that the presence of SMC in an older general practice population is a significant independent predictor for subsequent hospital-based dementia diagnosis. The authors concluded that the GP should inquire about memory complaints to identify vulnerable patients.
Quality reforms in Danish home care – balancing between standardisation and individualisation
- Author:
- ROSTGAARD Tine
- Journal article citation:
- Health and Social Care in the Community, 20(3), May 2012, pp.247-254.
- Publisher:
- Wiley
As a consequence, reforms of Danish home care policy for older people have placed a strong emphasis on quality since the 1990s. Yet, despite relatively generous coverage of the over-65 population, Danish home help services receive regular criticism in the media and public opinion polls. This article examines this reform strategy which represents a shift from the welfare state modernisation programme of the 1980s, built mainly on economic strategies of cost-efficiency and New Public Management principles. Recent reforms have instead attempted to increase the overall quality of care by increasing the transparency at the political, administrative and user levels. However, reforms have revolved around the conflicting principles of standardisation and the individualisation of care provision. This approach has succeeded in increasing the political and administrative control over home help at the expense of the control by users, care workers and case managers. Implications for the future are discussed.