New checklist may assist in early dementia diagnosis

A group of neuro psychiatrists and Alzheimer’s experts have developed a new questionnaire which may help to identify early warning signs of dementia.

The concept is that the checklist will help to recognise and measure something which is often easily overlooked; sharp changes in mood and behaviour which may indicate the beginning of the issues associated with dementia.
 
The group presented the 34-question checklist to the Alzheimer’s Association International Conference in Toronto last week.
 
With questions such as “Has the person become agitated, aggressive, irritable or temperamental” or “Has the person become more impulsive?” it may help family and friends to determine whether their loved one may be experiencing what is know as mild behavioural impairment. 
 
Mild Cognitive Impairment (MCI) has long been the diagnosis which describes people who can still complete most daily tasks but are experiencing some cognitive problems. The group of Alzheimer’s experts are now proposing that Mild Behavioural Impairment (MBI) be recognized as a precursor to MCI. 
 
It is suggested that early recognition of MBI will help to identify people at greater risk of developing Alzheimer’s in the future.
 
Although early detection is preferable with many conditions, with very little treatment available for dementia, will discovering you’re more likely to get it actually be a benefit?
 
Not necessarily, says Bupa’s Head of Dementia Services, Margaret Ryan.
 
Elderly woman with odd shoes
“We need to be careful even if we have the diagnostic tools, which is what they’re trying to do, because some people don’t want to know to be honest.

“It is a condition that is irreversible, it is progressive and it will be fatal if nothing else intervenes in the meantime. For a lot of people who will live with dementia in the future, the changes may happen in their brain 25 years prior,” says Margaret. 

While some behavioural changes may be occurring due to small amounts of damage happening in the brain, it may also be a personality issue due to the patient experiencing fear or frustration over changes they are noticing themselves.

“Sometimes the issue is not behavioral but people trying to cope. The brain is a very complex organ so people will try, consciously or subconsciously, to work out what’s going on for themselves and perhaps come up with coping mechanisms that help them to mask issues,” says Margaret. 

While a checklist may be able to alert people to future possibilities it is not definitive and may cause undue distress if incorrect conclusions are drawn on the basis of a questionnaire.

“Other things can mimic dementia, depression for example can make you lose words, memories, or make you act in ways that makes you seem strange to other people but that’s reversible and once people get that label of dementia, that has a load of implications for people’s lives,” says Margaret. “Like any tool that we use around diagnosis it needs to be used by someone who is very skilled.”

Behavioural changes can occur in anybody at any time and age, so a checklist such as this would only be looking for issues that have be manifesting for six months or so. For the moment the checklist is still in the research phase.
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