Difficulties in dementia diagnosis

Research studies have found many people are receiving incorrect dementia diagnoses, but Alzheimer’s Australia’s Dr Chris Hatherly, says the biggest concern is some people are “not being diagnosed at all”.

A new study, published in the journal Neurology, suggests that many people with early-onset Alzheimer’s do not get a proper diagnosis based on their symptoms.

The study looked at 40 people whose symptoms began between the ages of 46 and 60, and who had died and donated their brains to science. Autopsies revealed they had Alzheimer’s disease.

Medical records showed what their symptoms were and when they began.

Researchers found 15 patients had uncharacteristic symptoms, for instance, no memory impairment. Of these people, 53% had received an incorrect clinical diagnosis; the autopsies suggested Alzheimer’s disease, but they had received misdiagnoses of other neurological disorders, including other forms of dementia.

Dr Hatherly, who is project manager of the organisation’s National Quality Dementia Care Initiative, supported the Spanish study, telling DPS Publishing the misdiagnosis of dementia “definitely happens”.

“However, from the perspective of Alzheimer’s Australia, the biggest issue is the fact some people are not being diagnosed at all,” Dr Hatherly says.

“Some people aren’t even assessed. So, I guess the misdiagnosis goes both ways,” he says.

According to Dr Hatherly, the “best outcome is a timely diagnosis”, which is a diagnosis that happens “relatively early”.

“The sooner the cause of the symptoms is identified, the sooner treatment can begin,” Dr Hatherly says.

He says the early diagnosis sometimes helps the person come to terms with the prognosis and allows them to plan for the future, both on a personal and financial level. However, he says a downside is early diagnoses might be unwelcome for some people who are not ready to hear the harsh reality.

Professor of general practice at the University of Newcastle, Dimity Pond, says dementia is “very difficult” to diagnose.

Professor Pond, who recently conducted research into the diagnosis of dementia and depression, says her study revealed GPs find it difficult to diagnose dementia because of a number of “classic traps”.

“Patients’ medications, such as sleeping tablets, which can often make people feel dopey during the day, and others like heart tablets can cause problems with mental functioning,” she tells DPS Publishing.

“So, it gets a bit tricky and careful review needs to take place when it comes to diagnosing a cognitive disease like dementia,” she adds.

She says the most important issue at hand is depression in elderly people, which can likely be misinterpreted as “dementia symptoms”.

“Anyone, at any age, knows that being depressed can really, really impair a person’s ability to think clearly,” Professor Pond says.

“Sometimes when people display symptoms of dementia, including problems with their ability to think and reason, it could also just be the process of getting old.”

According to Professor Pond, attending memory clinics are the best for determining whether a person is displaying symptoms of dementia.

“We need more nurses and occupational therapists to go out into the community to look at the trouble with people’s cognitive function and their daily functions, such as shopping and preparing meals in order to make an informed diagnosis,” she says.

If you have a loved one suffering with dementia, we’re interested to know how their diagnosis was made and if it was an easy process. Let us know by making a comment below.