“Know dementia, know Alzheimer’s” is the theme for this year’s World Alzheimer’s Day with a focus on raising awareness of symptoms and diagnosis of dementia. Globally there are over 50 million people living with dementia, and this number is predicted to rise to 150 million by 2050.1 In both England and Wales the leading cause of death was Dementia and Alzheimer’s Disease in July 2021, accounting for over 10% of all deaths.2
Dementia is characterised by ongoing decline of cognitive functioning and has a number of potential causes including Alzheimer’s disease. Memory loss is a commonly recognised symptom of dementia, but there are a wide range of other symptoms associated with dementia including problems with problem solving, judgement, communication, and low mood.3 Although there is currently no cure for most causes of dementia, treatment can slow the progression of and help manage the symptoms of dementia. A wealth of research has been conducted and published on dementia, in this blog we would like to highlight a few select studies which have been published in BMJ Open.
It is crucial that dementia is diagnosed and support provided in the early stages of dementia as this can lead to improved prognosis and allow for advanced care planning. The rate of undetected dementia is almost 62% globally, according to a meta-analysis conducted by Lang et al. It was found that the prevalence of undetected dementia varied based on location; Europe and North America had lower rates of undetected dementia than India and China. Other factors which were associated with higher rates of undetected dementia included age <70 years, male gender, and a lower socio-economic status.4
Lang et al also found that family members may not recognise memory loss as an early symptom of dementia, and that frequent visits to a general practitioner (GP) were not always associated with detection of dementia. As such, it is important that both the general public and medical professionals are educated and aware of the symptoms of dementia so that a diagnosis can be made. A pre-post intervention study conducted by Tierney et al. found that participation in a workshop on diagnosis of and management of dementia improved the knowledge of general practitioner (GP) registrars and supervisors.5
Receiving a diagnosis of dementia can be difficult, Xanthopoulou and McCabe interviewed people recently diagnosed with dementia to explore their experiences of diagnosis and cognitive decline. People reported feeling loss of competence in daily activities, loss of security, and loss of identity. They also found that the time limitations in diagnosis and support appointments with medical professionals led to people receiving limited emotional support.6
In the UK one third of patients with dementia do not have a diagnosis recorded in primary care. GPs may be reluctant to inform patients that they suspect the patient has dementia or they may not have enough time during appointments to address dementia in patients with multiple conditions.7 Ford et al found, through a retrospective case-control study, that people with dementia that are known to a GP but do not have a recorded diagnosis can be detected using electronic care records. This can improve the data held on the number of people with dementia and allow for planning of dementia care and services.7
A large number of people are affected by dementia, and this is only set to rise. Raising awareness of symptoms and diagnosis of dementia is key to ensuring early diagnosis of, and providing support to, people with dementia.
More information on World Alzheimer’s Day can be found through Alzheimer’s Disease International:
https://www.alzint.org/get-involved/world-alzheimers-month/2021-theme/
And through the official social media tags:
#KnowDementia
#KnowAlzheimers
References:
1 Alzheimer’s Disease International [internet]. Virtually support World Alzheimer’s Month; c2021 [cited 17/09/21]. Available from: https://www.alzint.org/news-events/news/virtually-support-world-alzheimers-month/
2 Office for National Statistics [internet]. Monthly mortality analysis, England and Wales: July 2021; c2021 [cited 17/9/21]. Available from: https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/monthlymortalityanalysisenglandandwales/july2021#leading-causes-of-death
3 NHS [internet]. About dementia – Dementia guide; c2020 [cited 17/9/21]. Available from:https://www.nhs.uk/conditions/dementia/about/
4 Lang L, Clifford A, Wei L, et al. Prevalence and determinants of undetected dementia in the community: a systematic literature review and a meta-analysis. BMJOpen 2017;7:e011146. doi:10.1136/bmjopen-2016-011146
5 , et al. Workshops on diagnosis and management of dementia for general practitioners: a pre–post intervention study of dementia knowledge. BMJOpen
6 Subjective experiences of cognitive decline and receiving a diagnosis of dementia: qualitative interviews with people recently diagnosed in memory clinics in the UK.
7 , et al. Automated detection of patients with dementia whose symptoms have been identified in primary care but have no formal diagnosis: a retrospective case–control study using electronic primary care records.