Early dementia assessments ‘could lead to over diagnosis’ claim

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Dementia and geriatric medicine specialists writing in the British Medical Journal say that two thirds of over-80s could be diagnosed with dementia in future because doctors are subjecting older people to unnecessary tests and treatments.

Writing in the BMJ, the British and Australian experts in dementia, public health and geriatric medicine said the trend towards older people having their risk of dementia assessed could lead to over-diagnosis.

In the article they said: “The current prevalence of dementia is thought to be 10-30% in people over the age of 80, but the adoption of new diagnostic criteria will result in up to 65% of this age group having Alzheimer’s disease diagnosis and up to 23% of non-demented older people being diagnosed with dementia.”

Drive to early diagnosis a ‘worrying trend’?

“Only 5% to 10% of people with mild cognitive impairment will progress to dementia each year, and as many as 40%-70% of people do not progress or their cognitive function may even improve,” write the authors, who include Carol Brayne, professor of public health at Cambridge University.

The authors of the article claim that an early diagnosis can lead to patients taking unproven therapies such as gingko biloba to try to delay the onset of dementia, suffering stress, distress and possible stigma, or even contemplating suicide or euthanasia.

However supporters of early diagnosis say knowing that someone may develop dementia can let them draw up instructions for their future care, put their financial affairs in order and make lifestyle changes, such as eating healthily and taking more exercise, that will slow the disease’s progress.

The Alzheimer’s Society condemned the analysis.

Its chief executive, Jeremy Hughes, said: “It’s astounding to hear talk of an ‘unwanted war’ on dementia when in fact we need nothing less than an all-out fightback. We should be backing doctors up and down the country who are helping ensure people with dementia are diagnosed.”