Dementia: focus on care, diagnosis and therapies at the 15th National UK Conference

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Dementia is becoming a serious problem due to growth in the ageing population, and in the UK 820,000 people have the disease with Alzheimer’s disease being the most common cause of dementia. To address this, the Prime Minister’s challenge on dementia was launched last year to improve dementia care and research in the UK by 2015.

Last week, London hosted the 15th National Conference on Dementias, and BMC Medicine joined the 400 delegates who included old age psychiatrists, neurologists, geriatricians, GPs, policy makers, home care managers, social care workers and counselors.

The welcome address by Tom Arie and Alistair Burns was followed by an excellent talk from Martin Prince, who discussed the global prevalence of dementia and the WHO MHGAP programme on the packages of care for the detection and management of dementia in low resource settings. Another study termed PRIME, seeks to integrate packages of care in low and middle income countries with implementation and evaluation of the packages expected in the next few years. Continuing on the theme of care, Karim Saad described the West Midlands strategy for implementing care in the community and demonstrated how awareness of dementia has been raised in UK schools.

Diagnosis of dementia was discussed by John O’Brien in a presentation that highlighted beta-amyloid imaging for detection of dementia. In addition, a lively debate arguing whether dementia should largely be diagnosed in primary care concluded with most of the audience against the proposition. However, Roy Jones who was against the debate highlighted that primary care management of the disease is necessary.

The subject of clinical trials was covered in depth during the meeting with a comprehensive review by Roy Jones on the options for pharmacological treatment and immunotherapies for dementia. Other trials presented at the meeting included the iCST trial, which is a multi-centre UK study that seeks to evaluate a home-based individual Cognitive Stimulation Therapy (iCST) programme for people with dementia. Furthermore, the OPTIMA study showed that an increased dose of the rivastigmine patch has long term efficacy for patients with mild to moderate Alzheimer’s disease. Other approaches discussed included Souvenaid, a nutritional supplement that, according to results from the Souvenir II trial, is believed to enhance synaptic function and improve memory in patients with mild Alzheimer’s disease.

The common emphasis at the meeting was on early diagnosis of dementia to improve patients’ quality of life. The doubling of funds in dementia research through the government’s initiative will address this important point and the current proposals for prevention of dementia will be key in reducing the burden of disease at a national and global level.