When to suspect dementia

Abstract

With global dementia cases approaching 50 000 000, the importance of early and accurate diagnosis is crucial. Primary care clinicians are often the initial point of contact for people, their family and caregivers when dementia is first suspected. People who suspect they, or their loved one, may have dementia often experience significant fear and distress. Timely and accurate diagnosis, with an honest but compassionate discussion of dementia and its prognosis, may alleviate some distress by reducing time to diagnosis. Timely diagnosis may also enable opportunities to use disease-limiting treatments, reduce unnecessary testing and investigations and provides an opportunity to undertake advance care planning.

Living well with dementia

“…ACP is an ongoing conversation between healthcare professional and patient, sharing decisions and discussing preferences for ongoing care (Morris, Tomkow and Blakeman, 2022). Guidance suggests that ACP should start early, even shortly after diagnosis of dementia where appropriate (NICE, 2018).…”

“…Early diagnosis reduces uncertainty about symptoms and gives opportunity to commence disease-modifying treatments (Rasmussen and Langerman, 2019). The approach to assessing someone with suspected dementia in primary care is covered in our previous article ‘When to suspect dementia’ (Morris, Tomkow and Blakeman, 2022). Essentially, when dementia is suspected in a person presenting to primary care, physical examination and investigation should be carried out, including cognitive testing and National Institute for Health and Care Excellence (NICE) guidance suggests a referral to a memory clinic for diagnostic confirmation and classification.…”