NHS hospitals fail to spot dementia in more than a third of patients

Diagnosis missed in a third of all dementia patients who often need specialist support during ‘terrifying’ experience of hospital admission

Alex Matthews-King
Health Correspondent
Wednesday 25 April 2018 02:00
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The gap between diagnosis may be down in part to communication difficulties, said lead author Dr Andrew Sommerlad
The gap between diagnosis may be down in part to communication difficulties, said lead author Dr Andrew Sommerlad

NHS hospitals failed to identify that more than a third of all dementia patients who were suffering with the condition and were left without vital support when they are admitted to hospital, a study has found.

Among the people from an ethnic minority group who had dementia, 28 per cent had this missed in hospital, compared to 20 per cent of white patients.

Researchers from University College London (UCL) said these may be underestimates.

“People with dementia are more likely to be admitted to general hospitals for other illnesses, partly due to difficulties taking care of themselves, and once they’re in hospital those with dementia tend to have longer stays and face more complications,” the study's lead author, Dr Andrew Sommerlad, from UCL’s division of psychiatry told The Independent.

The failure to diagnose people could be down to low awareness of the signs of dementia among patients and their families and an increased likelihood of clinicians "misattributing" their symptoms to other conditions.

Charities warned that being in a strange environment, often in pain from a fall or infection and without carers, can be a “terrifying experience” for people with dementia.

This makes it crucial that the condition is picked up in hospital so they can get the best care, as well as appropriate support when they are sent home to help them understand their medications or care needs.

For the study, published in the journal Alzheimer’s and Dementia, researchers followed 21,300 people, of these 8,246 had previously been diagnosed with dementia in another setting.

In 2016 just 61.5 per cent of patients with dementia were appropriately diagnosed, however this is a significant improvement on 2008 when less than half (48.7 per cent) were given a correct diagnosis.

This is a sign that efforts to promote early detection and awareness of dementia, which has a range of causes most commonly Alzheimer's disease, the authors said.

Dr Sommerlad added: “Hospital records need to accurately reflect the patient’s condition so that doctors can tailor their care accordingly.”

He said communication difficulties are also likely to play a role in the gap between diagnosis of white and BAME patients, and so interpreters and culturally appropriate tests could make a difference.

There are 850,000 people with dementia in the UK and they occupy one-in-four beds in the NHS, according to Alzheimer’s Research UK.

As the number of people with the disease is expected to hit one million by 2021 the need for all staff to be able to diagnose dementia has “never been more pressing”, they added.

“Hospital can be a terrifying environment for people with dementia,” said Dominic Carter, senior policy officer at the Alzheimer’s Society charity.

“It’s crucial that admission staff are looking for signs and symptoms, so anyone affected can get the specialised support they need while they’re in hospital.”

Dr Matthew Norton, director of policy and impact at Alzheimer’s Research UK, who was not involved with the study, said: “This insightful study suggests that while hospital staff are aware of dementia generally, more work needs to be done to diagnose dementia in the earlier stages and avoid misdiagnosis. Many people with dementia today, particularly in BAME communities, are still not formally diagnosed, which presents challenges for delivering high-quality healthcare.”

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