GPs failing to diagnose dementia early
6 Aug 2010
New research by scientists from the Medical Research Council (MRC) suggests that patients could be missing out on early treatment options for dementia because GPs are failing to diagnose the condition early enough. The study, the first of its kind to analyse life expectancy after dementia is recorded by GPs, also shows that survival rates are much lower for those diagnosed by their GP than those who are actively screened for dementia in research studies.
Scientists from the MRC’s General Practice Research Framework (GPRF), with support from University College London (UCL), analysed the health records of over 135,000 people, aged 60 years or above, from over 350 UK practices between 1990 and 2007.
According to the research, for patients aged 60-69 the average life expectancy once diagnosed with dementia by their GPs was 6.7 years. Previous MRC research has shown that people in a comparable age range, actively screened for dementia as part of a research study, have a life expectancy of 10.7 years. The findings also revealed that mortality rates are more than three times higher in people with dementia in the first year after GP diagnosis, than in those without dementia. Scientists suggest this indicates GP diagnoses were made at times of crisis or much later in the lifecycle of the disease.
Dr Greta Rait from the MRC who led the study said:
“Until now most survival estimates have come from studies where people have been actively screened for dementia but the reality is that medical care for dementia patients tends to fall with family doctors. Our findings will help clinicians to make more realistic estimates of life expectancy for patients when they are diagnosed and also assist policymakers in planning services.
GPs are going to be dealing with more and more dementia cases in future and primary care must get better at detection. It’s therefore essential we conduct reviews and research like this.”
Chris Kennard, Chair of the MRC Neuroscience and Mental Health Board said:
“It’s clear that too little too late is being done to diagnose dementia. Without earlier diagnosis people may miss out on the opportunity to have early interventions, as new treatments come along. It’s estimated that 80 million people worldwide will be affected by dementia by 2040 so it’s crucial GPs are given the support and training they need to get to grips with identifying dementia accurately and as early as possible. The NHS has recently launched a national strategy for dementia and gave £150million over 5 years which will enable the establishment of memory clinics throughout the country to aid the early diagnosis of dementia. The findings of the research strongly support this approach.”
The study also found GPs were recording dementia in a non-specific way; not differentiating between Alzheimer’s disease and vascular dementia, which has implications for managing the disease over the long term. The scientists suggest this could be improved with training and incentives.
The study was funded by the North Central London Research Consortium and sponsored by UCL.