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Should we use ‘scare tactics’ in promoting the urgency of dementia?

 

A very fortunate happened yesterday. A London black cabbie had promised me to drive me to the ExCeL centre in London, if I paid him, to attend first day the main conference of the Alzheimer’s Association International Conference.

 

This year, there are no ‘sunny uplands’. There is normally pretty active pre-briefing of the latest phase III trial of a possible cure for dementia. Not this year.

 

But I found the atmosphere of all the junior and senior scientists to be ‘buzzing’. The amount of detail and rigour in scientific method in discovering the neural susbtrates of brain function, of relevance of Alzheimer’s disease, was phenomenal.

 

I last did my Ph.D. in Cambridge between 1997 and 2000 with Prof John Hodges, a world expert in the frontotemporal dementia form of dementia. Frontotemporal dementia is still an important cause of dementia.

 

That black cabbie told me how his mother had been ultimately diagnosed with dementia, although she was first misdiagnosed with dementia in a hospital by a locum doctor when she had a urinary tract infection. She didn’t know what day of the week it was. She thought she was in a hotel. She had heard of Margaret Thatcher though.

 

There is clearly progress being made in the accuracy of diagnosing dementia through biomarkers in cerebrospinal fluid. But I was a junior physician at the National Hospital for Neurology and Neurosurgery, it used to take me at least 30 minutes to get this sample off a patient from using a special needle. And even then that was for inpatients.

 

The aim is with a sophisticated knowledge of the molecular biology of the process causing an individual’s dementia we might be able to slow down its progression more effectively.

 

This is of course partly an admission that the current method of diagnosis by ‘clinical acumen’ is subject to too much error, but the essential issue remains that many in the UK still don’t receive their diagnosis of dementia on time. And the subsequent post diagnostic care and support, for both an individual with dementia and carer, can be not that good.

 

You can’t help feel but proud at the sheer devotion of the scientists around the world, in ‘fighting dementia’, but I on the whole wish they would simply say they love neuroscience. An orange being stripped of its segments and peel, from an advertising company for the Alzheimer’s Research UK, both attracted massive praise and some criticism.

 

Terms such as ‘burden’ still continue to exist with dementia, and there’s no doubt that there are negative aspects to dementia. But I know from close family, who are loved ones, who happen to have dementia, that there’s a lot more to them than the certainty of their diagnoses (or not).

 

 

@dr_shibley

 

 

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