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Study outlines dementia failings

Up to 27 million people worldwide have dementia but have not been diagnosed, according to a new report.

A major study found that up to three quarters of the estimated 36 million people globally living with dementia are undiagnosed and cannot benefit from treatment and care.

In high-income countries, including the UK, only 20% to 50% of dementia cases are recognised and documented in GP surgeries. A failure to diagnose often results from the false belief that dementia is a normal part of ageing, the study said.

The World Alzheimer Report 2011 found that drugs are more effective the earlier they are given to people, making a "strong economic argument in favour of earlier diagnosis and timely intervention". Early diagnosis could create savings of up to £6,254 per person, such as by delaying the need for people to go into care homes or hospital, it said.

In March this year, the National Institute for Health and Clinical Excellence (Nice) issued new guidance recommending that people with Alzheimer's in the mild to moderate stages of the disease should be given treatment with Aricept (donepezil), Reminyl (galantamine) or Exelon (rivastigmine). This was a rethink of 2006 guidance, which caused a national outcry, which said these drugs could be prescribed only to people in the moderate stage of Alzheimer's.

The report said drugs and psychological interventions for people with early-stage dementia "can improve cognition, independence, and quality of life", while also reducing the burden on carers.

Commissioned by Alzheimer's Disease International (ADI), the report was compiled by a team of researchers led by Professor Martin Prince at the Institute of Psychiatry, King's College London. They undertook the first systematic review of all the evidence on early diagnosis and early intervention for dementia and concluded that governments concerned about the rising costs of long-term care linked to dementia should "spend now to save later". They also pointed to a "treatment gap", where people miss out on drugs and therapies because they are diagnosed so late.

Prof Prince said: "There is no single way to close the treatment gap worldwide. What is clear is that every country needs a national dementia strategy that promotes early diagnosis and a continuum of care thereafter. Primary care services, specialist diagnostic and treatment centres and community-based services all have a part to play, but to differing degrees depending upon resources."

Jeremy Hughes, chief executive of the Alzheimer's Society, said: "In the UK right now 60% of people with dementia are struggling in the dark with no formal diagnosis. These people must be helped. Empowered with an early diagnosis, they can benefit from potential treatments and support which could vastly improve their quality of life."

A Department of Health spokeswoman said: "Improving dementia care is a priority for the Government. Early diagnosis is key as it allows people to plan for their future, preventing the need for crisis intervention and premature admission to acute hospital care. This delivers better outcomes for people with dementia, enabling them to live well."


From Belfast Telegraph