Monday, July 13, 2009

Do's and dont's in diagnosing dementia

An early diagnosis of Alzheimer's disease is critical for patients to plan for the future, get the best possible care and make the most of time with friends and relatives. However, current research suggests that less than 35% of people with Alzheimer's diseases or other dementias have a diagnosis of their condition in their medical records. Researchers from the University of Newcastle in Australia have been interviewing GPs (family doctors) to find out things that help and hinder them from making a diagnosis of Alzheimer's in their patients. They found helpful factors included:

  • a doctor's positive attitude to the diagnosis and treatment of dementia
  • having a trusting personal relationship with individuals who provide dementia support services
  • support from relatives and caregivers
  • a belief in the patient's right to know
  • a desire by GPs to be honest and open with their patients
Barriers to a diagnosis included:

  • differing health priorities among patients and GPs
  • GPs being dependent on patients and relatives to tell them about the symptoms of memory loss
  • GP's challenges with properly timing referral to support services
  • Fear of damaging the doctor-patient relationship
  • Caregivers with Alzheimer's downplaying their own needs

You can read more about this research at


Lex said...

Hey John,

Interesting summary. I have also started to see issues with people being diagnosed with Alzheimer's when they believe its a form of dimmensia instead, or they question the diagnosis because the patient was exposed to severe shock treatment therapy earlier on in life. Have you heard much about the debate there?

Also you seem to be pretty knowledgable in the research field. I have started up a blog to try to stimulate some debate but haven't had much luck as of yet. Do you have a general stance on th whole 'Recovery' movement hitting the psychological world?

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John Gale said...

Thanks for your comments. I'm not aware of the connection between shock treatment and dementia although this does sound interesting. As far as the Recovery movement goes we get quite a bit of interest in it here at the Bethlem Library and it is generally thought to be a good thing. The idea is - broadly speaking - not to aim at a medically-defined cure but to enable people with mental-health problems to feel properly part of society with fulfilling work, personal relationships etc even if they still have some symptoms. One of the most popular books we have on it is Social Inclusion and Recovery: a Model for Mental Health Practice by Julie Repper and Rachel Perkins published by Bailliere Tindall, 2003 ISBN 9780702026010
Best Wishes,

Lex said...

Hey John:

Thanks so much for your response! I hope you don't mind, but I quoted you on my own blog, Mental Health Recovery, and gave you full credit for the comment and a link to your blog for readers (of which there really aren't many...because it’s very new...but I'm working on it!).

Of course if you aren't comfortable with me quoting you I will of course remove the post! :)

Your response to Recovery is very interesting! As I mentioned in the post on my blog, the Recovery movement seems to be different based on the area you are in. For example, in Colorado it is all about a systematic treatment (similar to hierarchy intervention approaches) which focuses on both medication (so a medical cure) and empowerment via self-driven treatment. The full hierarchy intervention approaches are sometimes referred to as ‘holistic’ simply because they attack the whole of the problem…but that often gets a ‘new-agey’ feel to it so I’m hesitant in using that terminology for the sake of keeping the validity of the practice :)

On the East coast however, especially with the state hospitals, focus seems to be more on stabilization than treatment. The West coast is a bit of a mystery to me though, but I imagine it has taken on its own unique twist as well!

I also was researching it and there are some very different cultural implications for Recovery in the U.K. and New Zealand.

The U.K. for example stresses more peer mentorship and societal network support, whereas New Zealand (which mandated all mental health facilities take on a Recovery-based approach in...I think it was a 1997 Blueprint bill), seems to take on the idea that societal support, especially for the Maori minority who suffer from very high rates of mental disorders, is a moral obligation due to past imperialism.

Anyways I don't mean to blab, I actually submitted a few articles on the subject to so we will see if they get published, if they do I'd love to get your take on them.

Also if you would like to comment more on Recovery or anything at all I'd love to have more of your expertise on my Mental Health Recovery Blog.

Thanks for all your time and your expert opinions! Keep up the great work! We all love to read the newest posts.