Dementia: recognition and cognitive testing in community and primary care settings
Dementia is an umbrella term used to describe a group of symptoms characterised by behavioural changes, as well as loss of cognitive and social functioning brought about by progressive neurological disorders. There are approximately 944 000 people living with dementia in the UK and estimates indicate this will increase to over 2 million by 2051. Dementia, if left undiagnosed, can have an insidious and harmful impact on the people and their families who are affected by it. A timely diagnosis can be made when a person with a possible dementia comes to the attention of clinicians due to concerns about changes in their cognition, behaviour, or functioning. Community nurses are well-placed to observe changes in their older patients, which may be indicative of early dementia. This paper uses a case study to illustrate possible early signs of dementia and discusses the recognition and initial cognitive tests that can be used in a primary care setting.
Dementia is an umbrella term used to describe a group of symptoms characterised by behavioural changes, as well as loss of cognitive and social functioning brought about by progressive neurological disorders (Barber, 2020). There are over 200 subtypes of dementia, but the most common are Alzheimer's, vascular, Lewy Body, mixed dementia (often a combination of Alzheimer's and vascular) and frontotemporal dementias (Sandilyan and Dening, 2019) (Table 1). Based on prevalence modelling, there are estimated to be 944 000 people cur rently living with dementia in the UK and estimates indicate this will increase to over 2 million by 2051 (Wittenberg et al, 2019). Dementia is associated with old age; however, of the 944 000 people living with dementia, approximately 70 800 will be under 65 years old when diagnosed with (young onset) dementia (Carter et al, 2022). In England, due to their progressive nature, dementia and Alzheimer's disease remained the leading cause of death in February 2023 (for the 20th consecutive month), with 122.1 deaths per 100 000 people (5466 deaths) (Office for National Statistics (ONS), 2023). In March 2012, the Prime Minister set a challenge to deliver major improvements in dementia care (Department of Health (DH), 2012) that proposed three main goals for action:
Register now to continue reading
Thank you for visiting Community Nursing and reading some of our peer-reviewed resources for district and community nurses. To read more, please register today. You’ll enjoy the following great benefits:
Limited access to clinical or professional articles
New content and clinical newsletter updates each month