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Published on: November 5, 2012
by Tim Shipman for The Daily Mail:
The time it takes to diagnose dementia is to be slashed from 18 months to just three following a scientific breakthrough.
David Cameron will this week announce the creation of a chain of brain clinics to end the agony of those who find out they have Alzheimer’s when it is too late for help. Experts say early diagnosis will give those suffering from the early stages of dementia 18 months of extra independent living, transforming the lives of hundreds of thousands of vulnerable and elderly.
More than 400,000 people in Britain are suffering from dementia but are denied the care and support they need because their condition is undiagnosed – in part because they have to wait a year and a half for it to be confirmed.
But new technology, which will receive the Prime Minister’s backing this Thursday, will mean those suffering from memory loss or other potential symptoms will have their condition diagnosed in a sixth of the time. Patients at risk will be able to do a series of tests on an iPad in the comfort of their local GP’s office.
In only ten minutes the software can determine the difference between people with normal and abnormal memory.
Those at risk would then be referred to an NHS brain health centre where they would have more extensive memory tests while hooked up to an MRI scanner.
A new computer program can detect signs of dementia such as brain shrinkage and damage to blood vessels that can affect memory. The results would be beamed back to the GP.
The Government is also investing in a series of mobile diagnostic clinics which will park outside GP surgeries, so people can be tested on their own doorstep. The rate of successful diagnosis is expected to double from 42 per cent at present to 80 per cent – a target set by Mr Cameron earlier this year when he launched a Challenge on Dementia.
The PM has pledged to launch a campaign against Alzheimer’s to match the war on Aids in the 1980s and 1990s.
It is estimated that by 2020 there will be nearly one million people with dementia, rising from the current level of 670,000.
Mr Cameron said last night: ‘Dementia is a devastating disease that puts enormous strain on people and their families.
‘Prompt diagnosis makes an enormous difference to dementia sufferers.
This ground-breaking work from UK scientists and companies could change lives for the better and it underlines to the world that Britain is great for research and for business.’
The Government is investing £39million in the pilot project via a fund called Biomedical Catalyst that backs small and medium-sized businesses and universities to accelerate the development of most technologically-advanced healthcare.
The first ‘Brain Health Centre’ will be established at the Memory Clinic at Maudsley Hospital in South London.
The mobile van will run trials in Sussex. If they are a success they will be rolled out nationwide.
The Alzheimer’s Society will support the project by ensuring the needs of patients and their carers are fully considered in the project, and by undertaking an initial impact assessment on the 200 patients assessed in the two trial Brain Health Centres.
Six out of ten people living with dementia in the UK have not received a diagnosis.
Experts say the problem is that many people have never raised the problem with their GP, or may have been misdiagnosed, or are simply waiting for a diagnosis.
DELAYS THAT LAST FOR MONTHS
The current way a patient is diagnosed with dementia is both unwieldy and lengthy. In fact, there is no set referral pathway for those who complain about memory problems to their GP.
A doctor may ask the patient to come back in a few months, may put the problem down to old age, or may conduct a basic pencil and paper memory test. Eventually a patient may be referred to a memory clinic, where other GPs will identify whether a problem exists.
At that point the patient may be diagnosed, may be sent for a brain scan, or may be referred to a psychiatrist or neurologist in a regional centre.
Guidelines mean patients should not wait more than 18 weeks for an appointment with a specialist, but high demand means it often takes much longer.
Once they have an appointment at a hospital – usually in a major city or specialist hospital – they could have to travel long distances to get there.
Usually the patient will then be given a memory test, and may, but not always, have an MRI or CT scan. The test is assessed by a neurologist or a psychiatrist.
Any brain scans are assessed by a radiologist, who uses their expertise to judge whether there is a problem. At that point the patient may get a diagnosis. The whole process from start to finish can take up to 18 months.
Under the proposed system, any patient with memory problems will be given a ten-minute test by a GP, using newly developed software on an iPad. It will immediately identify whether a patient is at risk of dementia.
They hope the proposed system will make diagnoses quicker and more accurate – and the ease and access to scanners will mean people are not put off seeking help.
The Alzheimer’s Disease International charity says earlier diagnosis allows those with dementia to plan ahead while they still have the capacity, and crucially, make decisions about their own care.
Early interventions can also allow doctors to improve cognitive function, treat depression and delay institutionalisation – giving a patient more time to live independently.
High blood pressure and a lack of exercise have also been linked to the onset of the dementia, and researchers are investigating whether early changes to lifestyle may slow the progression of the disease.
Jeremy Hughes, chief executive at the Alzheimer’s Society, said: ‘There are 800,000 people living with dementia in the UK, but fewer than half of people with the condition have a diagnosis.
As numbers double and costs soar, developing new and earlier ways of diagnosing the condition is imperative.
‘This technology could potentially reduce the time people need to wait for a diagnosis significantly.
After diagnosis, we also need to ensure that people are supported with information and services to enable them to gain the full benefits and support that a diagnosis can give.’
Professor Alistair Burns, the national clinical director for dementia, said: ‘Combining innovative technologies in this way should help us to spot early signs of dementia, giving us time to offer patients better support and care.’
The project is being run by the companies IXICO and Cambridge Cognition, which developed the iPad software, in partnership with King’s College London, the Universities of Brighton and Sussex and Imperial College London.
Picture: Timothy Fadek/Corbis
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