challenging dementia in brent dr justin kington, locum consultant psychiatrist central & north...
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Challenging Dementia in BrentDr Justin Kington, Locum Consultant Psychiatrist
Central & North West London NHS Foundation Trust
Panel: Improving early diagnosis
25th October 2013
Alz society website Oct 2013
A hospital perspective…
Dementia diagnostic process
A recent case
70 year old woman
Visual hallucinations for 3 years
Memory decline
Falls, getting slower
Is this dementia?
Can anything be done to help her?
What is the best time and place to make a diagnosis?
Hospitals & dementia
Why diagnose dementia early?
Why diagnose dementia early?
Why are we even asking?
Why do we treat people with dementia differently?
Why diagnose dementia early?
1.People want to (and have a right to) know
Why diagnose dementia early?
1.People want to (and have a right to) know
2.We need to rule out other diseases
Why diagnose dementia early?
1.People want to (and have a right to) know
2.We need to rule out other diseases
3.We have effective symptomatic treatments
Why diagnose dementia early?
1.People want to (and have a right to) know
2.We need to rule out other diseases
3.We have effective symptomatic treatments
4.To help with decision-making
Why diagnose dementia early?
1.People want to (and have a right to) know
2.We need to rule out other diseases
3.We have effective symptomatic treatments
4.To help with decision-making
5.To bring dementia ‘out of the shadows’
A recent case…
70 year old woman
Visual hallucinations for 3 years
Memory decline
Falls, getting slower
Brent
Estimated 2400 people with dementia (2012)
Current rate dementia diagnosis: 43.8%
Brent – more very old people
Increase in the very old population by 2021
75+ (18000 to 23000, 28%)
85-90 (50%)
90+ (2200 to 4300, 95%)
Brent – concerns for the future
1. Very high levels of obesity (children)
2. High levels of inactivity
3. High levels of cardiovascular disease
4. Highest rate of diabetes in England
5. Dementia risk is higher in some ethnic groups
Brent – presenting in crisis
“A&E is used in Brent as an alternative to primary care “NHS Brent commissioning plan 2009-2014
The future
Alz society website Oct 2013
The future
Bringing dementia ‘out from the shadows’
Alz society website Oct 2013
“Alzheimer’s disease is amongst the most significant social, health, and economic crises of the 21st century.”
World Alzheimer Report 2011, Alzheimer’s Disease International
“Dementia is one of the biggest challenges we face today – and it is one that we as a society simply
cannot afford to ignore any longer.”
The Prime Minister, Prime Minister’s Challenge on Dementia 2012
“…dementia must be recognised as a challenge for society.”
Dementia 2012, Alzheimer's Society
“…one of the greatest challenges presented by our ageing population.”
Unlocking diagnosis, All-Party Parliamentary Group on Dementia