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Dementia: A NICE-SCIE Guideline on Supporting People With Dementia and Their Carers in Health and Social Care

Dementia: A NICE-SCIE Guideline on Supporting People With Dementia and Their Carers in Health and Social Care

NICE Clinical Guidelines - National Collaborating Centre for Mental Health (UK)

Version: 2007

PREVENTION, EARLY IDENTIFICATION, ASSESSMENT AND DIAGNOSIS OF DEMENTIA

Prevention of dementia syndromes would have a huge impact on large numbers of individuals and on society as a whole. Primary prevention, to avert early pathological changes, or secondary prevention, to delay pathological processes, are strategies that seem worthwhile pursuing. To do this, we must understand the factors that increase the risk of developing dementia and those that appear to be protective. Earlier identification of dementia may allow secondary prevention interventions, as well as early mobilisation of support and resources. To achieve earlier identification, we need to understand the ways in which cognitive function in dementia syndromes diverges from normal ageing processes. Diagnosis of dementia and its subtypes is often a complex process in which practitioners need to consider personal and informant histories, cognitive function testing and exclusion of other organic and psychological disorders. The importance of structural and functional neuroimaging is debated, as are the respective roles of primary- and secondary-care specialists in the diagnostic process. This step-wise process of reaching a diagnosis of dementia may involve assessment by a number of different professionals over a period of time. The process may raise difficult questions about how to discuss the possible or actual diagnosis, with whom and when. The experience of this assessment process may influence the way in which the person with dementia and his or her family or other carers assimilate and accommodate themselves to the diagnosis, and professional skills in managing the assessment process are therefore of great importance.

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