Many Alzheimer's Cases Go Unrecognized: Report

Late diagnosis hinders even the limited treatments available, experts say

By Steven Reinberg
HealthDay Reporter

TUESDAY, Sept. 13 (HealthDay News) -- Diagnosing and treating Alzheimer's disease early is essential if patients are to benefit from the medications currently used for this dementia, a new report stresses.

However, most people with the condition are diagnosed late in the progression of the disease, which results in a "treatment gap" that limits access to information, treatment, care and support, according to the report released Tuesday by Alzheimer's Disease International. All this compounds the problems for patients, families, caregivers, communities and health professionals.

"The most important thing about this report is that it confirms the importance of early diagnosis and that interventions are possible because of it for Alzheimer's and other dementias," said Robert J. Egge, vice president for public policy and advocacy at the Alzheimer's Association.

In the United States, Alzheimer's and other dementia are a "crisis," he said. "Part of what makes it a crisis is that it is so under-recognized. One of the places it is not recognized is in the doctor's office."

Many patients go undiagnosed, which means even the limited treatments available aren't started soon enough, he said. Doctors need to be aware of dementia and how to diagnose it early, Egge added.

But there is a worldwide lack of awareness, he noted.

"Failure to diagnose Alzheimer's in a timely manner represents a tragic missed opportunity to improve the quality of life for millions of people," Dr. Daisy Acosta, chair of Alzheimer's Disease International, said in a statement from King's College London. "It only adds to an already massive global health, social and fiscal challenge."

Patients, according to Egge, say one of their biggest problems is getting their condition recognized. "They feel like they are adrift too often, with their loved ones trying to care for them without support," he said.

According to the report:

  • Of the estimated 36 million people with dementia worldwide, 75 percent have not been diagnosed.
  • Failure to diagnose is based on the false belief that dementia is a normal part of aging and nothing can be done about it.
  • Drugs and psychological treatment can improve cognition, independence and quality of life.
  • Governments should spend money on diagnosis and treatment to reduce the costs of care later.

"Over the past year, the research team has reviewed thousands of scientific studies detailing the impact of early diagnosis and treatment, and we have found evidence to suggest real benefits for patients and caregivers," Marc Wortmann, executive director of Alzheimer's Disease International, said in the statement.

The report recommends that governments:

  • Teach physicians and other health care professionals to detect dementia early.
  • Create networks of specialist centers to confirm early-stage dementia and enact care plans.
  • Publicize interventions that are effective in improving cognitive function, treating depression, improving caregiver mood and delaying institutionalization.
  • Spend more money on research.

"There is no single way to close the treatment gap worldwide," lead report author Dr. Martin Prince, from King's College London Institute of Psychiatry, said in the statement. "What is clear is that every country needs a national dementia strategy that promotes early diagnosis and a continuum of care thereafter. Primary care services, specialist diagnostic and treatment centers and community-based services all have a part to play, but to differing degrees, depending upon resources."

For patients, Egge suggested that people who think they have dementia "pursue the diagnosis when you see the warning signs of Alzheimer's or other dementia; seek out care from professionals; let them know your concerns and pursue this until you get the answers you need."

More information

For more on Alzheimer's disease, visit the U.S. National Library of Medicine.

SOURCES: Robert J. Egge, vice president, public policy and advocacy, Alzheimer's Association; King's College London, statement, Sept. 13, 2011; Sept. 13, 2011, Alzheimer's Disease International, World Alzheimer Report 2011 "The Benefits of Early Diagnosis and Intervention"

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