It is regularly criticized that the detection of dementia in primary care is not effective enough, especially with regard to early stages of dementia. Previous research results suggest that there are reservations among general practitioners towards dementia diagnostics. So far, however, the causes for this or the positions and strategies of general practitioners towards dementia care have not been sufficiently investigated. The aim of the study was to investigate the attitudes of general practitioners towards dementia diagnostics, to identify common challenges in day-to-day practice and to derive starting points for optimization. In the course of a survey, which was developed on the basis of a separate preliminary interview study, 425 general practitioners in Rhineland-Palatinate were interviewed (survey period: November 2017 - January 2018). The results show that a considerable part of the doctors surveyed have withdrawn from dementia diagnostics and delegated the care of dementia patients exclusively to the medical specialist level. From the data material, various reservations and challenges can be summarized, which can be seen as barriers to the effectiveness of primary care for dementia patients: 1) Low self-efficacy perception towards dementia, 2) differential diagnosis as hurdle, 3) challenges in doctor-patient communication, 4) lack of remuneration, 5) low involvement of practice staff members, 6) more negative attitudes towards dementia diagnosis due to lack of geriatric education, 7) limited cooperation with and knowledge of regional counseling and care services. Several starting points can be identified to further optimize the GP dementia diagnoses and care: 1)Increasedawareness of options beyond therapeutic interventions, 2) differential diagnosis and care pathways, 3) doctor-patient communication, 4) remuneration and incentives, 5) involvement of practice staff members, 6) higher sensitivity due to geriatric education, 7) cooperation with and knowledge of dementia care and counseling services.