RCPE Press Release

07 September 2012

***EMBARGO: NOT FOR BROADCAST OR PUBLICATION BEFORE 00:01HRS 7 SEPTEMBER 2012***

Doctors will meet today at an event convened by the Royal College of Physicians of Edinburgh (RCPE) [1] to consider how to improve diagnosis of patients with dementia, as it is estimated that up to 50% of patients with dementia in Scottish hospitals go undiagnosed.

Dementia is a common and progressive illness and is now present in 25% of all Scottish hospital in-patients and over 40% of over-70s admitted to hospital. Up to 50% of these cases will be undiagnosed. To put this in context, new data has highlighted that approximately 100 patients in a hospital the size of the Royal Infirmary of Edinburgh, and 1600 patients in hospitals across Scotland, are estimated to have undiagnosed dementia at any one time [2]

Patients with dementia are highly vulnerable and studies have shown that there is a significantly higher risk of death related to their condition during, and in the 6 months following, admission to hospital. Undiagnosed dementia can also result in inappropriate care, delays in receiving appropriate treatment, increased length of hospital stay and a reduction in the length of time that patients may be able to live independently at home.

As the number of people with dementia has increased with our ageing population, so have the pressures on medical staff in hospitals. Most acute hospitals have Medicine for the Elderly (formerly ‘Geriatrics’) wards, but the current structure of training does not universally include training in the diagnosis and assessment of cognitive disorders (including dementia).

Against this background, the RCPE has convened a national meeting at which doctors will consider how to improve diagnosis and treatment for patients with dementia in hospitals [3].

Prof Emma Reynish, Professor of Dementia Research, University of Stirling and Consultant Geriatrician, Victoria Hospital, Kirkcaldy, who will be speaking at the RCPE meeting, said,

“The problem of underdiagnosis of dementia in the UK has been well documented in work done by Alzheimer Scotland and the Alzheimer’s Society.   Health Boards in Scotland are doing better than elsewhere in tackling this problem. Nevertheless older people in hospital are increasingly more likely to have dementia that is undiagnosed. 

“Latest estimates would indicate that there are as many as 1600 patients with undiagnosed dementia in Scottish hospitals at this time. It is vital that dementia is recognised early in order to ensure that patients and those who care for them receive appropriate treatment and care. When a person experiencing symptoms of confusion or memory problems is admitted to hospital this presents a positive opportunity to do an initial assessment and to consider the possibility that it may be dementia-related.”

Prof Alasdair MacLullich, Royal College of Physicians of Edinburgh, and Professor of Geriatric Medicine, Royal Infirmary of Edinburgh, said,  

“The diagnosis and assessment of dementia presents a major challenge to medical staff in hospitals who until recently have not needed to be trained in its diagnosis and treatment.  Medical training must evolve in line with the evolving “dementia epidemic” to ensure that medical staff are trained in diagnosing, assessing and treating dementia.  Additionally there must be sufficient numbers of trained doctors to cope with this increasing burden of disease”.

Henry Simmons, Chief Executive, Alzheimer Scotland, said,

“We greatly welcome this focus on improving the rates of dementia diagnosis in Scotland’s hospital. There have been some significant improvements made to NHS training for acute staff within the Promoting Excellence framework. However, this still relies on staff being aware that the person in question has dementia, which is currently difficult unless they have an existing diagnosis. It is only with a diagnosis that we can ensure not only more appropriate hospital care, but also offer better information, advice and community-based support for the person and their family”.

ALCOHOL-RELATED BRAIN DAMAGE

Doctors will also hear at this meeting of the impact of alcohol on the brain beyond the all too familiar effects of acute intoxication. Alcohol can contribute to long term brain damage, including in younger people. Care needs can be extensive, including for those who recover because that process can be slow and incomplete. The care system for this group should be better developed.

Contact: Graeme McAlister (RCPE) on 0131-247-3693 or 07733-263453; or Kirsty Yanik (Alzheimer Scotland) on 0131 243 1453 or 07900 498223

ENDS

Notes for Editors.

[1] The RCPE is a professional membership organisation, of hospital (medical) specialists, with over 10,000 Fellows and Members throughout Scotland, the rest of the UK and internationally.

[2] Estimate, as at September 2012, derived from ISD statistics.

[3]The RCPE Hot Topic Symposium on ‘The Confused Patient in the Acute Hospital’ will take place at the RCPE, 9 Queen Street, Edinburgh, on Friday 7 September 2012 from 9.00am – 4.45pm