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Independents' Day

RCGP backs drive to boost dementia diagnosis rates by 50%

The RCGP has backed the Government’s drive to boost dementia diagnosis rates by 50%, but warns that GPs need extra funding to hit the targets and that patients must not have early diagnoses ‘forced’ upon them.

Some patients will find it distressing to receive an early diagnosis and should not be cajoled into having assessments, said RCGP chair Professor Clare Gerada.

Her comments follow health secretary Jeremy Hunt’s announcement that he wants to increase ‘shockingly low’ dementia diagnosis rates in England from 45% to 66% by 2015.

GPs have been offered a controversial DES - for dementia case-finding - this year that will involve practices opportunistically offering an assessment for dementia to ‘at-risk’ patients during routine consultations.

But Professor Gerada said: ‘GPs are committed to improving the care we provide to patients with dementia - and we acknowledge that earlier and more accurate diagnosis can enable people with dementia and their families to make more informed choices and decisions about their future care, whilst they still have the capacity to do so.

‘We welcome the personal commitment of the prime minister and the health secretary on this crucial issue. We hope that today’s announcement will now translate into proper funding and resources, directed where they are most needed.’

A GP who advises NHS England on public health is calling for the introduction of mental agility testing in NHS Health Checks scheme to increase diagnosis rates for dementia.

Dr Charles Alessi, also chair of the National Association of Primary Care, said the Montreal Cognitive Assessment (MoCA) test could be provided in the NHS Health Check to provide an indicator of early cognitive impairment.The test typically features questions on language, memory and attention.

Dr Alessi said people can delay or prevent symptoms with good diets and exercise and stopping smoking.  ‘This condition – which we thought was hopeless – can also be delayed. We can influence this so I think we should.’

But Dr Chris Fox, a clinical senior lecturer in dementia at the University of East Anglia, said rolling out  dementia screening will be a ‘disaster’.

He said: ‘The problem is that diagnosis can turn someone’s life upside down years before dementia itself does. The main thing that comes with a diagnosis of early dementia is a deeply unfortunate label. And in most cases the stigma attached will do far more harm than good.’

Readers' comments (4)

  • So on Dr Alessi's recommendation, why don't we just promote "good diets and exercise and stoping smoking" to all over 65? Far more productive and cost effective I think.

    One of my patient was screened as (doubtful) possible dementia last week and referred to specialist. She now complains her travel insurance has shot up and finds it difficult to visit her kids in Australia. I'm sorry, I should have never offered the screening test........

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  • Emer MacSweeney

    Another option which may be less stigmatising is one of the clinical trials for people with Mild Cognitive Impairment (generally MMSE between 20 and 26). Such trials are designed for people with mild but measurable memory impairment but no symptoms of dementia, so there is no "label". Anyone that can travel to London 11x in the next 18 months can join the trial we're involved in and it's free

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  • There are clear criteria for deciding whether it is worth introducing a screening programme - see e.g. .

    One of the criteria is the existence of an affordable and acceptable treatment for the condition. Are we convinced that the resources are there to provide necessary treatment for dementia cases?

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