Your correspondent asks that GPs assessing for possible dementia should see the person “with a family member who can give examples of the changes the person is experiencing” (Letters, 17 September). They are not alone in the frustration of specialist referral being declined on the basis of a cognitive test alone.
I hope it might help to know that this holistic approach is already the official advice for patients and GP practices. The NHS website says: “It helps if someone who knows you well is also with you, as they can help describe any changes or problems they’ve noticed.” The guideline from the National Institute for Health and Care Excellence tells clinicians: “Do not rule out dementia solely because the person has a normal score on a cognitive instrument.”
The GP practice is still the right starting point, to check for reversible conditions that can affect how well the brain works. However, this is another example of why clinicians must take heed when patients and families say “something’s not right”.
Tim Sanders
Leeds
• I was interested in the letter about cognitive functioning tests as a means to diagnose dementia. My wife completed these tests several times with no diagnosis as a result, although my daughters and I were certain that she was showing evidence of the illness. After she had finally been diagnosed, a psychiatrist administered the test again and told me that it showed development of my wife’s symptoms. By this time her opportunity for specialist treatments had been delayed by at least two years, and it’s too late for her to benefit from them.
It should be added that in recent times the question “Who is the current prime minister?” has become much more challenging.
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