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Room for improvement in dementia diagnosis



Above: Alzheimer’s Australia CEO, Glenn Rees.

By Stephen Easton

Between 50 and 80 per cent of people with dementia in high income countries like Australia are not diagnosed in primary care, according to the 2011 edition of the World Alzheimer’s Report, released last week by Alzheimer’s Disease International (ADI).

The report, The benefits of early diagnosis and intervention, notes evidence showing that earlier diagnosis can be achieved, through education programs for GPs and practice nurses, diagnostic and early stage dementia care services and more effective interaction between different components of the health system.

Its authors, from Kings College London, also found evidence in existing research that early interventions are effective in treating depression, improving cognitive function and delaying any move into residential care, as well as improving caregiver mood.

Glenn Rees, CEO of Alzheimer’s Australia, said the ADI report’s findings were consistent with a new paper released by Alzheimer’s Australia as part of Dementia Awareness Week, entitled Timely diagnosis of dementia: Can we do better?

Mr Rees said the report, published by the University of Newcastle, blamed several factors for delays in diagnosis, including the false belief that dementia is a normal part of ageing, denial on the part of the individual and family, the complexity of diagnosing dementia and doctors being reluctant to damage their relationships with patients.

He added that Australian health authorities had always considered dementia as an issue within the aged care policy area, and needed to regard it as a chronic disease instead.

“I think the significance of the two reports … is that they really underline that dementia policy is at a crossroads, in the sense that we now know dementia develops decades before diagnosis,” he said.

“So you have to ask, ‘Should the policy and research focus only be on the terminal and end stages, or should it be on the pre-symptomatic stage, the mild cognitive impairment stage when you first see the symptoms, or the stage when the person has had a dementia diagnosis?’”

Mr Rees said that Alzheimer’s Australia hoped the report would influence health policy, leading to more services for those with early stage dementia, and help to promote awareness in the wider community of the extent of undiagnosed cases.

“Consumers have been saying [to Alzheimer’s Australia] for many years that a key priority for them is the amount of time it takes to get a diagnosis of dementia … and [so is] the fact that doctors don’t refer people to the services that are available,” he said.

“We’ve been advocating that medical stakeholders and consumers should get together and identify the barriers to diagnosis and identify the strategies that might work.

“[The Alzheimer’s Australia report] sets out a lot of the information we think policy people need, to start making some change. If the Department [of Health and Ageing] and the medical profession had gotten together and done the job, we wouldn’t have had to.”

The report has the support of the Australian Medical Association’s president, Dr Steve Hambleton, who provided a foreword acknowledging its importance and that of the issues it highlights.

“It is an important part of a GP’s work to be familiar with the clinical symptoms of dementia and listen to the family carers who are likely to be the best positioned in providing information about the cognitive capacity of the individual,” Dr Hambleton writes.

“We must look carefully at the barriers to timely diagnosis that are identified in this paper and assess strategies that have been described for addressing those barriers. It is crucial that any future primary care reforms have a greater focus on improving the care that patients get at the service level.”

Raising worldwide and community awareness

Organisations throughout Australia and the world will mark World Alzheimer’s Day tomorrow with a variety of events, designed to raise awareness about the disease.

The date falls in the middle of Dementia Awareness Week, run by Alzheimer’s Australia and its state branches, which goes until Monday 26 September.

This year’s theme, ‘Worried About Your Memory?’ aims to encourage those who have concerns about their ability to remember facts to seek help.

Here is a brief overview of some of the goings on around the country.

The Forget Me Not Girls, Alzheimer’s Australia’s Young Ambassadors, will hold their second fundraiser at the Pavilion in the Botanical Gardens, Sydney on Saturday 24 September. All money raised will go towards Alzheimer’s and dementia research and care.

There will be an array of canapés and beverages on offer, complemented by dance floor tunes and of course, an after party. Items will also go up for auction. 

Tickets are now available by clicking here.

– Director of the Centre for Studies on Prevention of Alzheimer’s Disease at McGill University and the Douglas Mental Health Research Institute in Canada, Dr John Breitner, has been travelling around the country to discuss diagnosing dementia early. To find out when he will visit your state, click here.

– Tomorrow, there will also be a special event in Sydney featuring Australian dementia experts Professor Henry Brodaty and Nicola Lautenschlager, and President of Alzheimer’s Australia, Ita Buttrose.

For more information visit the Alzheimer’s Australia website.



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