As the number of people with cognitive impairment and dementia continues to grow at an alarming rate, medical and scientific communities worldwide are seeking ways to help those affected, their families and our communities adapt to best manage the effects of cognitive diseases (1). New drugs and treatments are continually being developed and we have considerably more knowledge about the causes, effects and progress of Alzheimer’s and other dementias. But for now – and for the foreseeable future – there is no cure.
Nonetheless, early diagnosis of dementia is considered important and beneficial for several reasons (2):
- available treatments can be prescribed sooner, when they are most likely to help reduce symptoms
- allows the individual time to access information, resources and supports that will support independent living for as long as possible
- people in the early stages have the chance to take control, be prepared and plan for their future
- family, friends and caregivers can learn how to best assist their loved ones
The next question is: what is the best way to do this? The answer isn’t easy or obvious and is further complicated by the nature of the disease itself. People with dementia often aren’t aware they have a memory problem – or are in denial – so are not likely to mention it to their doctors. And even if they do, health care providers may believe symptoms are simply normal signs of aging (2).
A recent systematic review of 13 studies (including 4 randomized controlled trials) is considered the first to measure the number – and accuracy – of dementia diagnoses that resulted from a wide variety of dementia detection approaches, including screening at memory clinics, regularly scheduled home visits by geriatric nurses, widespread distribution of information pamphlets, and physician education programs to help doctors better recognize the early stage symptoms of dementia (3). The studies varied widely in terms of their scope and scale, the number of participants, the duration of the trials and the quality of the evidence.
What the research tells us
After being educated about the disease, its symptoms and testing methods, doctors were more likely to suspect dementia in a higher proportion of patients, but not always accurately. In fact, more education did not reliably help doctors determine which patients actually did have dementia or diagnose them any earlier. There was evidence from individual studies that screening at memory clinics and regular home visits by a geriatric nurse may be useful ways to identify patients with dementia earlier. Distributing education leaflets about dementia did not appear to help increase diagnosis rates (3).
Further research is strongly recommended to strengthen the findings and to address important issues not covered in this review – notably, the cost effectiveness of the various approaches and screening options.
Also important to keep in mind (and noted by the review authors) is that even an accurate diagnosis might not change people’s behaviour or decisions about treatment, support or planning for the future (3,4). However, often concerns about memory problems (by the individual or their families) are the reason people seek screening for dementia, so providing a diagnosis to address these concerns is worthwhile.
Want to learn more about the warning signs of cognitive impairment or dementia and when to take your concerns to a doctor?
Watch our public talk with Jay Ingram and Dr. Christopher Patterson "The Science of Alzheimer's: Where are we going?" Dr. Patterson describes the 10 warning signs of dementia at 24min.
Click here to read our blog about the clock drawing test and driving.