I was interested to read Alastair Stewart’s advice to see your GP if you experience cognitive difficulties, which might be symptoms of dementia (Alastair Stewart reveals he has been diagnosed with dementia, 10 September).
My 72-year-old husband has been experiencing similar difficulties in recent years – forgetting things he’s always known, forgetting what we’ve just said, forgetting where things are, forgetting how to do complex things. He has seen his GP twice in the last year or so about it. Unfortunately, the standard tool available to GPs seems to be the mini mental state examination, which is a gross, broad-brush assessment that doesn’t pick up smaller changes. On both occasions the GP has decided that his score is within the range of “normal ageing”, and not referred him for specialist services. However, my husband and I both know that his changes are greater than “normal ageing”.
The GP is the gatekeeper to specialist services, including medication that is only effective for mild dementia. As long as a GP’s only tool is a broad-brush assessment that will only identify more severe dementia, my husband will be denied services or medication until his difficulties become too severe to benefit from them.
GPs need a subtler tool, including perhaps asking the person to make a second appointment with a family member who can give examples of the changes the person is experiencing.
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