Understanding early diagnosis of dementia

Focusing on a faster way to determine cognitive impairment so that we can work quickly to help patients and their families.

The rates of dementia diagnosis in Australia are on the rise – in fact, it’s thought there will be more than 500,000 people with dementia by 2025 and over a million by 2056, according to healthdirect.

The most common cause of dementia is Alzheimer’s disease, which is associated with distinctive changes in the brain. While Alzheimer’s disease can develop in younger people, it is most likely to happen after the age of 65.

The difficulty is, many people believe that memory problems are a normal part of ageing. Furthermore, there’s a perceived stigma attached to dementia, there is no cure and many worry about what the future holds.

These are among the reasons why there are relatively low rates of cognitive screening in the community and hospital setting.

However, it’s more important than ever to achieve an early diagnosis so that the patient can still participate in the decision making process about their treatment plan, living and financial arrangements and the services that can help improve their quality of life.

Testing and diagnosing dementia usually begins with a visit to the GP, who will refer the person to a specialist such as a geriatrician, neurologist, psychogeriatrician, psychiatrist or neuropsychologist.

Melbourne Geriatricians Group, for example, then conduct a memory assessment and help patients and families overcome the stress involved in dealing with common behaviours shown by people with dementia.

These symptoms can include:

  • Heightened aggression;
  • Agitation;
  • Anxiety;
  • Delusions;
  • Hallucinations;
  • Wandering; and
  • Sexual/social inhibition.

NEW WAYS TO SCREEN FOR DEMENTIA

There are many screening instruments available to help diagnose dementia. Given dementia can affect people of all backgrounds, it is important to have tools that are not influenced by language, education or gender.

The paper Retrospective study and development of the miniRUDAS as a possible cognitive screen tool explores how the Rowland Universal Dementia Assessment Tool can be adapted to include 10 questions rather than 30 to help form a diagnosis.

The research showed a miniRUDAS combining visuoconstructional, judgement and memory recall was highly correlated with total RUDAS scores.

This means, subject to further evaluation, a miniRUDAS could be developed for GPs and healthcare professionals to conclude if the patient has cognitive impairment in less time than current diagnostic methods.

By making diagnosis easier, we can begin treatment options faster so that older Australians with dementia can live their best life.

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