HAVING dementia diagnosed is devastating, but finding out early can help patients and families reconcile themselves to the situation. It’s worrying, then, that GPs – the first point of medical contact for dementia patients – take an average of 18 to 30 months to make a diagnosis, according to GP (May 25). Sometimes it takes four years.

Forty per cent of GPs are reluctant to diagnose dementia early, says Dr Louise Robinson, a Newcastle GP who has researched dementia and ageing. She told the Primary Care Neurology Society Conference in Birmingham: “This may be down to a variation in skills among GPs, a lack of specialist mental health services or a tendency for preferring watchful waiting.” But she adds: “It is not for GPs to decide when to tell patients [that] they have dementia. Patients want to know as soon as possible so they can have a say in the matter.” Dr Ken O’Neil, a GP in Glasgow, agrees it is important to diagnose dementia early. But he says it will “have a minimal affect on the actual progression of the disease”.

Dr Stephen Iliffe, a London GP who has helped to develop national dementia guidelines, says applying the dementia label wrongly could prove very hazardous. “GPs are cautious when making a diagnosis because of the actual difficulty in distinguishing early cognitive impairment from normal ageing and depression.”

Pulse (May 24) reports from the same conference, saying that secondary services are so overwhelmed that they send patients back to GPs, who then have to wait until symptoms get worse before rereferring patients. “People with memory difficulties who are not appropriate for secondary care or old age psychiatric services are often being fed back to primary care,” says Dr Robinson.

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