Ask Dr Trisha: Dementia diagnosis

Ask Dr Trisha: Dementia diagnosis

NHS England recently announced a new scheme which will pay GP surgeries £55 every time they formally diagnose someone with dementia. It is estimated that of the 800,000 people in the UK who are thought to have dementia, fewer than half have been diagnosed and this is why NHS England have started this initiative.

The payment has raised concerns, but this is a valid effort to improve life for people struggling (often unknowingly) with dementia. That £55 doesn’t go to the individual GP, but to the surgery as a whole. Raising awareness and funding dementia diagnosis in this way could lead to better care for dementia patients and more support for their families.

Diagnosing dementia can be very difficult. It’s rare for someone to come to see their doctor because they think they have dementia. There is no simple blood test or scan available. GPs have to talk at length to the patient and their family. They take a careful history of problems to spot signs and symptoms that might point to a correct diagnosis. They also have to rule out many other conditions that affect brain function such as thyroid problems or anaemia.

Dementia can affect any area of your brain, so as well as memory loss, symptoms also include changes in mood such as anxiety, fear and aggression, difficulty carrying out tasks – following a recipe or paying a bill for example; trouble communicating and keeping a thread of conversation, as well as changes in behaviour such as being uninhibited or wandering. There may be worrying signs at home, such as self-neglect, uneaten food and general chaos. These things aren’t always easy to pick up.

Doctors and nurses use mental tests such the Mini Mental State Examination, or the MOCA score, to formally assess brain functioning. An extra £55 per patient could be used to employ a specialist dementia nurse or to help fund a dedicated memory clinic so more people can be diagnosed.

Making a diagnosis of dementia is just the beginning. A lot of advice needs to be given and support put in place. Dementia has implications for every aspect of life and it’s a progressive condition. There is also treatment to be considered although this is currently fairly limited, helping slow progression for some people and managing symptoms (especially behavioural problems) for others.

If you are worried that you or a relative may have dementia, talk to your GP or encourage the person to
do so as soon as possible. It’s not an easy time, but sorting out a diagnosis will help you or your loved one lead
a relatively independent life for as long as possible.

Q. I’ve heard that fruit juice is bad for us, but how can it be when we are supposed to have at least five fruit and veg portions a day?

Dr Trisha says: Fruit juice has been condemned because of its sugar content and acidity. While it does contain natural fruit sugars, which provide about 33-46 calories per 100ml, there’s little evidence to suggest that these sugars are of significant risk to your health.

Look for 100 per cent juice with no added sugar and stick to the serving size. Fruit juice is a source of fibre and you can include one portion (150ml) in your five-a-day but no more because it contains less fibre than whole fruit. It’s also packed with vitamins and minerals, especially Vitamin C, folate and potassium, all of which are good for your health.

  • Dr Trisha writes a column every fortnight in Yours magazine. Ask Dr Trisha about your health problems by emailing