A 12 month drive has seen Leicester GP practices diagnose a significantly higher number of dementia patients than the UK national average, exceeding the local target and beating its own diagnosis rates from last year.
The news means more patients living in Leicester have benefited from a timely diagnosis thanks to a continued commitment from Leicester City CCG over the past year. Each year all CCGs in the country are set a target, based on their patient population, by NHS England to improve diagnosis rates for people with dementia aged 65 and over. This was as a result of national data collected which showed that only 48% of the estimated number of people with dementia had a formal diagnosis.
Between 1 April 2016 and 31 March 2017, Leicester City CCG was given a target of
diagnosing 67.6% (1,821) of their expected number of patients aged over 65 with dementia. In total, the CCG diagnosed 2,457 patients in the age category – which means 91.2% of the estimated number of people with dementia now have a diagnosis. This also means the CCG has diagnosed 24% more dementia patients than the national average and the second highest number of patients within the East Midlands region, as well as increasing diagnosis locally by 3%.
Dr Sulaxni Nainani, Leicester City CCG Board member and GP lead for older people and dementia, said: “We are delighted to be achieving such positive results for our patients year after year. However, we will continue the drive on diagnosis. We will continue to work closely with our local health and social care partners to improve awareness and remind people of the importance and benefits of a timely diagnosis. It means patients and their family members or
carers can receive the support they need earlier to help live independently for as long as possible.”
Over the last 12 months Leicester City CCG has continued to work ever closer with GP practices to understand their dementia register list each month, so they were able to keep track of how well they were diagnosing and flag any targets that were not being met. Care Navigators, who support Leicester City patients to remain in their own home, have also received fantastic dementia training, so for the last 12 months they have been able to perform mini memory tests if they or the GP has any concerns about the patient’s memory.
Dr Sulaxni Nainani continued: “Once someone has a confirmed diagnosis of dementia there are services to support both the patient and those around them. These include the Alzheimer’s Hospital Liaison Service at the Leicester Royal Infirmary, Leicester City Council Dementia Care Advisors, Age UK, Alzheimer’s Society and the Care Homes Mental Health inreach team. Community memory clinics, tea and coffee mornings and singing cafes are also provided by Leicester City Council.”
The word dementia describes a set of symptoms that may include gradual memory loss and difficulties with thinking, problem-solving or language. These symptoms occur when the brain is damaged by certain diseases, including Alzheimer’s and stroke. However, these symptoms could also be caused by a number of other health conditions such as another illness, reaction to medication or experiencing a stressful time, so it is extremely important to make an appointment to see a GP.
HIV-related cognitive impairment
Alzheimer’s disease is the most common cause of dementia, but there are many rarer diseases and conditions that can lead to dementia, dementia-like symptoms or mild cognitive impairment. Rarer forms of dementia account for only around 5 per cent of all dementia cases in the UK.
HIV-associated neurocognitive disorder (HAND)
HIV causes an infection that weakens the immune system, making it harder for the body to fight infections and disease. HIV infection can cause a number of different problems in the brain, which affect up to half of people with HIV. This is known as HIV-associated neurocognitive disorder (HAND).
Difficulties with memory, thinking and reasoning (aspects of cognition) are common with HIV, but they are usually mild and dementia is much rarer. Before the use of antiretroviral drugs (medication that helps to control HIV), around 20-30 per cent of people with advanced HIV infection previously developed dementia. This figure has now decreased to around 2 per cent.
Neurocognitive disorders in people with HIV may be caused by the virus directly damaging the brain. They may also be the result of a weakened immune system enabling infections and cancers to attack the brain.
Symptoms may include problems with short-term memory, learning, speed of thinking, difficulties with concentration and decision making, unsteadiness and mood changes. People may also have problems with their sense of smell.
Some people with HIV may experience only a few very mild symptoms, such as a decline in the ability to think quickly or clearly. These mild impairments do not amount to dementia.
HIV is easily overlooked as a possible cause of dementia. Even when someone is known to have HIV infection, cognitive impairment can sometimes be difficult to diagnose. This is because the symptoms are similar to those of other conditions, such as depression.
Treatment with a combination of at least three antiretroviral drugs often prevents cognitive impairments worsening and, for many people, can reverse the cognitive damage caused by HIV. Rehabilitation programmes may also help people with HAND to re-learn skills.