World Alzheimer Report 2011 - The benefits of early diagnosis and intervention

World Alzheimer Report 2011

The World Alzheimer Report 2011 shows that there are interventions that are effective in the early stages of dementia, some of which may be more effective when started earlier, and that there is a strong economic argument in favour of earlier diagnosis and timely intervention.

Key findings
• Dementia diagnosis provides access to a pathway of evidence-based treatment, care and support across the disease course.
• Perhaps as many as 28 million of the world’s 36 million people with dementia have yet to receive a diagnosis, and therefore do not have access to treatment, information, and care.
• The impact of a dementia diagnosis depends greatly upon how it is made and imparted.
• Evidence suggests that when people with dementia and their families are well prepared and supported, initial feelings of shock, anger and grief are balanced by a sense of reassurance and empowerment.
• Earlier diagnosis allows people with dementia to plan ahead while they still have the capacity to make important decisions about their future care. In addition, they and their families can receive timely practical information, advice and support. Only through receiving a diagnosis can they get access to available drug and non-drug therapies that may improve their cognition and enhance their quality of life. And, they can, if they choose, participate in research for the benefit of future generations.
• Most people with early stage dementia would wish to be told of their diagnosis.
• Improving the likelihood of earlier diagnosis can be enhanced through: a) medical practice-based educational programs in primary care, b) the introduction of accessible diagnostic and early stage dementia care services (for example, memory clinics), and c) promoting effective interaction between different components of the health system.
• Early therapeutic interventions can be effective in improving cognitive function, treating depression, improving caregiver mood, and delaying institutionalisation. It is simply not true that there is ‘no point in early diagnosis’ or that ‘nothing can be done’. Some of these interventions may be more effective when started earlier in the disease course.
• Available evidence suggests that governments should ‘spend to save’ – in other words, invest now to save in the future. Economic models suggest that the costs associated with an earlier dementia diagnosis are more than offset by the cost savings from the benefits of anti-dementia drugs and caregiver interventions. These benefits include delayed institutionalisation and enhanced quality of life of people with dementia and their carers.

To prepare the report, ADI commissioned researchers Prof Martin Prince, Dr Renata Bryce and Dr Cleusa Ferri at the Institute of Psychiatry, King's College London, to undertake the first-ever, comprehensive, systematic review of all of the evidence on early diagnosis and early intervention for dementia.

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