November 2022
The search for life-changing dementia treatments is beginning to yield tangible results. Now is the time for primary care to adapt to diagnosing people at the earliest stages of dementia, when treatments are most likely to be effective.
An early and accurate dementia diagnosis helps people to access the right care and support and gives them the opportunity to take part in clinical research. Unfortunately, for many people, getting an accurate diagnosis often takes too long and happens too late.
But there is hope. With over 140 drugs for Alzheimer’s disease currently in clinical trials and the recent positive results from a phase III clinical trial of lecanemab, it is a matter of when, not if, life-changing treatments become available. When they do, it will be more important than ever to be able to diagnose people early enough for new treatments to be effective.
A person’s journey to diagnosis typically starts with their GP, and primary care settings continue to play a crucial role at various stages along the dementia diagnosis pathway. Our health system must adapt and evolve to diagnosing the diseases that cause dementia earlier, and primary care needs to be part of that evolution.
Our report identifies some of the ways primary care could evolve given the right support, not only to address the difficulties we face now, but to prepare us for a future where the diseases that cause dementia can be treated effectively.
Improving dementia diagnosis: what could change in primary care?
Our recommendations:
1. The Dementia 10-Year Plan for England currently in development should:
- Establish infrastructure across the NHS that allows for more effective data-sharing between primary care and other settings.
- Address immediate backlogs and workforce issues in primary care that are holding back the recovery of the dementia diagnosis rate to pre-pandemic levels.
- Provide strategic, long-term support and investment in primary care to prepare for the expected prevalence of dementia in the future.
- Pave the way for innovation to be piloted and adopted in primary care.
2. Integrated Care Systems should be supported to ensure primary care practitioners receive appropriate training.
3. Primary Care Networks should explore and invest in the best diagnostic pathways for their patients, including innovative diagnostic tests and alternative service models such as Brain Health Clinics.
4. Investment is needed to improve how data is curated and shared between primary care and memory assessment services.
5. The National Institute for Health Care Excellence (NICE) should work with clinicians, people living with or affected by dementia and the third sector to develop national clinical guidelines on the diagnosis of people living with Mild Cognitive Impairment.