National Institute for Health and Clinical Excellence (NICE)
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Report renews calls for early diagnosis of dementia

Early diagnosis is necessary to improve the treatment, information and care given to people with dementia, according to a new report.

The World Alzheimer Report 2011from Alzheimer's Disease International warns that in higher income countries, such as England, between 50 and 80 per cent of dementia cases are not being recognised in primary care.

One reason identified for the missed diagnoses is the false belief that memory problems are a normal part of ageing.

The report calls for earlier identification and diagnosis, in line with NICE's guidelines on dementia.

NICE recommends that staff in primary care should consider referring people who show signs of mild cognitive impairment (MCI) for assessment by memory assessment services.

These services can then help determine whether there are signs of dementia, so that care can be planned at an early stage.

If MCI is identified, the memory assessment services should offer follow-up to monitor cognitive decline and other signs of possible dementia, to plan care at an early stage.

In addition, healthcare professionals who carry out health checks for people with learning disabilities should be aware that they have increased risk of dementia.

This also applies for healthcare professionals carrying out health checks for people in other high-risk groups, such as people with Parkinson's disease, or those who have had a stroke.

With an ageing population, the report states that earlier diagnosis can lead to better treatment.

In particular, it allows people a greater ability to plan their own lives after diagnosis, and to make important decisions about future treatment and care.

Marc Wortmann, Executive Director of Alzheimer's Disease International, said: “Over the past year, the research team has reviewed thousands of scientific studies detailing the impact of early diagnosis and treatment, and we have found evidence to suggest real benefits for patients and caregivers.

“Earlier diagnosis can also transform the design and execution of clinical trials to test new treatments.

“But first we need to ensure that people have access to the effective interventions that are already proven and available, which means that health systems need to be prepared, trained and skilled to provide timely and accurate diagnoses, communicated sensitively, with appropriate support.”

Professor Martin Prince of the Institute of Psychiatry, King's College London, and main author of the report added: “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 centers and community-based services all have a part to play, but to differing degrees depending upon resources.”

To help improve dementia services, the Department of Health yesterday pledged to invest £10 million in memory services to identify people with dementia earlier and treat them more effectively.

Care Services Minister, Paul Burstow said: “While there is no cure for dementia, we know that early diagnosis and early intervention can help people take control of their condition and plan for the future.

“With access to the right services and support, people with dementia can continue to live well for many years. Memory services have a really important role to play in this.”

NICE's guidance includes a NICE Pathway on dementia, bringing together related guidelines, implementation tools and the dementia quality standard.

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