Challenging Dementia in BrentDr Justin Kington, Locum Consultant Psychiatrist

Central & North West London NHS Foundation Trust

Panel: Improving early diagnosis

25th October 2013

Alz society website Oct 2013

A hospital perspective…

Dementia diagnostic process

A recent case

70 year old woman

Visual hallucinations for 3 years

Memory decline

Falls, getting slower

Is this dementia?

Can anything be done to help her?

What is the best time and place to make a diagnosis?

Hospitals & dementia

Why diagnose dementia early?

Why diagnose dementia early?

Why are we even asking?

Why do we treat people with dementia differently?

Why diagnose dementia early?

1.People want to (and have a right to) know

Why diagnose dementia early?

1.People want to (and have a right to) know

2.We need to rule out other diseases

Why diagnose dementia early?

1.People want to (and have a right to) know

2.We need to rule out other diseases

3.We have effective symptomatic treatments

Why diagnose dementia early?

1.People want to (and have a right to) know

2.We need to rule out other diseases

3.We have effective symptomatic treatments

4.To help with decision-making

Why diagnose dementia early?

1.People want to (and have a right to) know

2.We need to rule out other diseases

3.We have effective symptomatic treatments

4.To help with decision-making

5.To bring dementia ‘out of the shadows’

A recent case…

70 year old woman

Visual hallucinations for 3 years

Memory decline

Falls, getting slower

Brent

Estimated 2400 people with dementia (2012)

Current rate dementia diagnosis: 43.8%

Brent – more very old people

Increase in the very old population by 2021

75+ (18000 to 23000, 28%)

85-90 (50%)

90+ (2200 to 4300, 95%)

Brent – concerns for the future

1. Very high levels of obesity (children)

2. High levels of inactivity

3. High levels of cardiovascular disease

4. Highest rate of diabetes in England

5. Dementia risk is higher in some ethnic groups

Brent – presenting in crisis

“A&E is used in Brent as an alternative to primary care “NHS Brent commissioning plan 2009-2014

The future

Alz society website Oct 2013

The future

Bringing dementia ‘out from the shadows’

Alz society website Oct 2013

“Alzheimer’s disease is amongst the most significant social, health, and economic crises of the 21st century.”

World Alzheimer Report 2011, Alzheimer’s Disease International

“Dementia is one of the biggest challenges we face today – and it is one that we as a society simply

cannot afford to ignore any longer.”

The Prime Minister, Prime Minister’s Challenge on Dementia 2012

“…dementia must be recognised as a challenge for society.”

Dementia 2012, Alzheimer's Society

“…one of the greatest challenges presented by our ageing population.”

Unlocking diagnosis, All-Party Parliamentary Group on Dementia