Undiagnosed dementia worries raised

Sep 7 2012

Older people being treated in hospital are increasingly more likely to have dementia that is undiagnosed, doctors in Scotland have said.

Statistics show that dementia is present in 25% of all inpatients in Scotland and in around 40% of inpatients aged over 70, according to the Royal College of Physicians of Edinburgh (RCPE).

As much as 50% of all the cases will be undiagnosed, meaning that at any one time an estimated 1,600 people in Scottish hospitals will have dementia without knowing it, it said.

Doctors are meeting at an RCPE event to discuss how to improve diagnosis and treatment for patients who have the condition. They will also hear about the impact of alcohol on the brain beyond acute intoxication.

Dementia research professor Emma Reynish, from the University of Stirling and who is also a consultant geriatrician at Victoria Hospital in Kirkcaldy, said the problem of under-diagnosis is well documented in previous work.

She said: "It is vital that dementia is recognised early in order to ensure that patients and those who care for them receive appropriate treatment and care. When a person experiencing symptoms of confusion or memory problems is admitted to hospital, this presents a positive opportunity to do an initial assessment and to consider the possibility that it may be dementia-related."

RCPE is calling for medical training to evolve in order to diagnose the condition, as undiagnosed dementia can result in inappropriate care and an increased length of hospital stay.

Most acute hospitals have "medicine for the elderly" (formerly geriatrics) wards, but the current structure of training "does not universally include" diagnosing and assessing cognitive disorders such as dementia.

Henry Simmons, chief executive of the charity Alzheimer Scotland, said: "We greatly welcome this focus on improving the rates of dementia diagnosis in Scotland's hospitals. There have been some significant improvements made to NHS training for acute staff within the Promoting Excellence framework.

"However, this still relies on staff being aware that the person in question has dementia, which is currently difficult unless they have an existing diagnosis. It is only with a diagnosis that we can ensure not only more appropriate hospital care but also offer better information, advice and community-based support for the person and their family."