More than half your patients can’t tell dementia from the normal signs of ageing
GPs sit in the driving seat when it comes to dementia in the UK, writes Professor Alistair Burns
The challenge the UK faces with dementia is one of the biggest issues in healthcare. It's a problem that is only going to grow: the number of people diagnosed and living with dementia is expected to double to nearly 1.4m in the next 30 years.
Yet the diagnosis rate remains quite low at just 42% on average. Detection is a significant opportunity to improve the lives of people and their carers affected by dementia because, contrary to popular misconception, it is possible to improve the lives of people with dementia, so long as it is picked up at an early stage.
Timely diagnosis therefore requires a committed focus – and to that end a new Department of Health awareness campaign, supported by the Alzheimer's Society, will start this week. The campaign aims to raise awareness of the symptoms of dementia and encourage individuals to discuss their concerns with their GP.
We know that early diagnosis helps people living with dementia to better understand their condition, enables access to treatments that could help relieve their symptoms, and gives them and their families time to plan for the future, however significant the barriers.
Recent research showed more than half of people in the UK lack the confidence to distinguish dementia from the normal signs of ageing. Additionally, the stigma of dementia can prevent open discussion. This taboo and misconceptions such as the belief that dementia is part of normal ageing, and that little can be done to treat it, inhibits access to the quality care on offer to those living with the disorder.
The new campaign will address these issues by improving awareness of the symptoms of dementia among the general public. It will convey the fact that it is possible to live well with dementia. Importantly, the campaign will also signpost people to local support services, in particular their GP.
The RCGP and Department of Health are collaborating to develop a set of tools that are designed to assist GPs in both diagnosis and managing the stages of dementia. The toolkit will cover early identification of signs and symptoms, diagnosis, and treatment of co-morbid conditions, all the way through to end of life care. In the meantime, the DH's e-learning source is available to provide guidance on recognising, assessing and managing dementia.
GPs are in the driving seat on dementia: nobody knows patients and carers better than their own doctors. As the first point of contact for those worried about themselves or a loved one, colleagues in primary care are best placed to help rule out other conditions that may have similar symptoms to dementia, or other possible causes of confusion or emotional upset. It is vital that GPs are aware of the help on offer as well as the local services such as memory clinics that are available.
When we talk about promoting public awareness and of the importance of timely diagnosis, critical murmurs about the impact of over-diagnosis are often thrown up. Will the system cope with additional referrals? Is it really necessary to ‘drive' people into surgeries? Given what we know about many people's difficulty – either experienced or anticipated – in talking about dementia, encouraging as many people as possible to seek professional assessment of any signs and symptoms of dementia that they, or their loved ones, are exhibiting, is essential.
Colleagues in primary care have already played a critically important role in reducing prescriptions to treat dementia. A Health and Social Care Information Centre (HSCIC) report found there was a 52% reduction in the number of people with dementia receiving a prescription of medication from 2006 to 2011. This is a great example of the imperative role primary care plays in improving the care and quality of life of people with dementia. Now, we have to expand primary care's role and interest to ensure more successes and turnarounds like these are made. In dementia, a timely diagnosis is the cornerstone to improving care.
Professor Alistair Burns is the National Clinical Director for Dementia and a professor of old age psychiatry at the University of Manchester