May 2021

Old Age Psychiatrists’ views on diagnosing and treating Alzheimer’s disease before dementia

The success of future disease modifying treatments that aim to slow the progression of Alzheimer's disease rely heavily on the ability to diagnose patients in the earlier stages of disease, before the onset of clinical symptoms. Given that the first life-changing treatment may shortly be available, the pressure to ensure that the health system is ready to deliver treatments is increasing.

In a joint project with the Royal College of Psychiatrists, Alzheimer's Research UK explored the diagnostic and service challenges faced by Old Age Psychiatrists in the UK, and how services would need to adapt in order to deliver future treatments.

Are we ready to deliver disease modifying treatments?

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We found that psychiatrists are keen to embrace new treatments and see memory services as holding a key role in their provision. However, significant challenges experienced in current practice need to be resolved to make this possible. Some of the primary barriers faced include:

  • Limited access to the necessary resources to support early diagnosis of Alzheimer's disease.
  • Inconsistency in the use of terminology and guidelines for the early stages of disease.
  • Concerns were raised about the benefits of early diagnosis to patients.

Due to these and other concerns, only 36% of psychiatrists thought that their services could adapt to deliver disease modifying treatments within a year. This report proposes key recommendations that should be addressed now to ensure that life-changing treatments reach patients as quickly as possible once they are approved:

  1. The NHS should dedicate specific funding to increase diagnostic infrastructure and improve equity of access.
  2. The NHS should work with key organisations to commission a clinical pathway that would meet the needs of patients to access a disease modifying treatment. This would need commitment from NHSE/I, devolved nation equivalents and clinical organisations to ensure the development and delivery of key service improvements.
  3. A commitment across the clinical community to develop and use consistent clinical terminology for early Alzheimer's disease.