Dementia - Timely Diagnosis and Management

PHN activities help to improve the timely diagnosis, management, and support of people in the region who are living with dementia, as well as their carers and families.

One of the biggest issues facing those living with dementia, health professionals and carers - and our ability to implement appropriate management and care strategies - is that only 50 per cent of all dementia cases in Australia are diagnosed. The average delay between family members and close friends observing dementia symptoms and obtaining a diagnosis is over three years.

Early intervention can reduce the impact of dementia on clients, their carers, and families, and improve their quality of life, however it begins with timely assessment and diagnosis.

What is dementia?

Dementia is a chronic, progressive, and terminal condition, consisting of a cluster of symptoms. There are over fifty subtypes of dementia, and each is associated with specific neurodegenerative pathology occurring in the brain. The most common forms of dementia are Alzheimer’s dementia, vascular dementia, and mixed Alzheimer’s and vascular dementia, followed by Lewy body dementia, frontotemporal dementias, and dementia due to Parkinson’s disease. Other less common forms include alcohol-related dementia, HIV-associated dementia, and dementia due to Huntington disease.

Early signs are subtle and may be difficult to discern, even for those close to the person concerned. The person with dementia may also have trouble recognising any changes within themselves. Early features vary a great deal and depend on the underlying brain pathology. Importantly, while memory difficulties may be the first sign, impairment to language, behaviour, or personality, and/or disruption to everyday tasks may also be an early sign.

Timely assessment and diagnosis

Timely diagnosis begins to enable a person living with dementia and their family to:

• Adjust to the diagnosis of dementia
• Prepare for the future
• Access appropriate medical intervention
• Manage other symptoms such as behaviour and mood changes
• Review and manage current medications.

Symptoms that are similar to dementia can be caused by several different diseases and conditions, some of which are treatable and reversible (including infections, thyroid imbalances, depression, medication side-effects or nutritional deficiencies).

The quicker an assessment can be undertaken the sooner appropriate management and treatment can begin.

Dementia can be diagnosed when there is a gradual decline in cognition, behaviour and/or personality that:

• Interferes with everyday function (work, social and /or domestic function); and
• Represents a decline from previous levels of functioning and performing; and
• Cannot be explained by an acute or chronic medical condition, neurological condition, delirium, or a major psychiatric disorder.

Evidence collected in an assessment needs to be sufficient to determine a dementia subtype (differential dementia diagnosis) to ensure appropriate treatment and management.

The ELDAC Dementia Toolkit supports end of life care for people living with dementia and their families.

What does the PHN do to support dementia services in the region?