How Doctors View Dementia Compared to Other Common Health Problems


Contributed by: Dennis Fortier, President, Medical Care Corporation
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As we note often in this space, there is a significant gap between the state of our scientific knowledge about Alzheimer's (and other causes of dementia) and the actual standards of care that most patients receive when they visit their physician.

This problem, which is not limited to the dementia field, may be particularly noteworthy in the dementia field because an intense research effort is moving the field quickly forward and busy physicians cannot stay current with the rapid pace of scientific discovery.

A recent study published in the Journal of the American Geriatrics Society has clearly documented one factor that contributes to this gap. It is physician attitudes about their own ability to help patients and their perceptions about the availability of outside support resources.

In the study, primary care physicians were surveyed on their attitudes toward three common problems that they face in clinical practice; heart disease , diabetes, and dementia. The following trends were clearly noted:

More PCPs strongly agreed that:
  • older patients with dementia are difficult to manage (23.8%) than for heart disease (5.0%) or diabetes mellitus (6.3%);
  • PCPs can improve quality of life for heart disease (58.9%) and diabetes mellitus (61.6%) than for dementia (30.9%);
  • older patients should be routinely screened for heart disease
    (63.8%) and diabetes mellitus (67.7%) than dementia(55.5%);
  • their organizations have expertise/referral resources to manage diabetes mellitus (49.4%) and heart disease (51.8%) than dementia (21.1%)
In my opinion, the 2nd and 4th points may have a strongest detrimental effect on care.

The second point suggests that physicians are unaware of how much they can improve a patient's health through timely intervention, a careful diagnosis, and proper treatment of the dementing disorder at hand.

The 4th point probably prevents PCP's from offering appropriately constructive care plans to the families of demented patients. If they do not feel there are adequate systems and support resources for demented patients in their communities, they may choose to temper expectations and resign the family to an unnecessarily dire prognosis.

Education for the public will play a major role in the fight against Alzheimer's and other forms of dementia but clearly, a strong dose of physician education will also be required.

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2 comments :

  1. Good article. My mother died yesterday, she'd had dementia for years but was only diagnosed a year ago. The stupid general practitioners didn't know what to look for and didn't do any tests. Her life would've been a lot more comfortable before death, if she'd had an early diagnosis.

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  2. Several recent articles indicate Alzheimer's Disease (AD) is a prion disease.

    " http://www.santacruzsentinel.com:80/localnews/ci_12180851
    UCSC researchers find key to prion diseases
    By Alia Wilson

    Posted: 04/20/2009 01:30:05 AM PDT



    "“Human prion diseases include classic and variant types of Creutzfeldt-Jakob disease, mad cow disease, Alzheimer's and Parkinson's."


    http://sludgevictims.com/pathogens/ALZHEIMERS-CJD-samepriondisease.doc

    http://sludgevictims.com/alzheimer.html

    Researchers have found prions in blood, urine, saliva and feces of human and animal victims of Transmissible Spongiform Encephalopathies (TSEs - prion diseases).
    ********************************************************************************************************************************************

    "OPKO Health Announces Development of Blood Test for Alzheimer’s Disease
    February 11, 2010 10:47 AM Eastern Time
    MIAMI--(EON: Enhanced Online News)--OPKO Health, Inc. (NYSE Amex:OPK) today announced the development of a
    simple diagnostic blood test for Alzheimer’s disease. The test, designed to detect elevated levels of antibodies unique
    to Alzheimer’s disease, was approximately 95% accurate in initial testing. "

    http://eon.businesswire.com/portal/site/eon/permalink/?ndmViewId=news_view&newsId=20100211006100&newsLang=en
    **************************************************************************************************************

    http://www.ncbi.nlm.nih.gov/pubmed/16127436
    Nat Med. 2005 Sep;11(9):982-5. Epub 2005 Aug 28.

    Detection of prions in blood.
    Castilla J, Saá P, Soto C.

    Department of Neurology, University of Texas Medical Branch, 301 University Boulevard, Galveston, Texas, 77555-0646, USA.


    "These findings represent the first time that PrP(Sc) has been detected biochemically in blood, offering promise for developing a noninvasive method for early diagnosis of prion diseases."

    ***************************************************************************************************************

    http://www.sciencealert.com.au/news/20091310-19987-2.html

    Tuesday, 13 October 2009




    "The human prion is resistant to both heat and chemicals and is reported to be up to a hundred thousand times more difficult to deactivate than the animal form of infective agent which causes well known diseases in cattle, such as mad cow disease, and scrapie in sheep. "

    Any error in identifying a CJD-carrier can be fatal and costly - many hospitals around the world have been forced to destroy millions of dollars worth of instruments when patients were diagnosed with CJD some time after undergoing routine eye and neurosurgical procedures.

    A further factor limiting decontamination from prions is that existing cleaning protocols are damaging to medical instruments such as flexible endoscopes and some instruments used in neurosurgical, dental and opthalmological procedures."

    *********************************************************************

    There are 5.3 million AD victims in the United States, with a new case every 70 seconds - an epidemic of almost a half million new cases of a transmissible prion disease each year. The CDC and medical community must promptly deal with the issue of potential iatrogenic transmission of Alzheimer's Disease.

    Helane Shields, PO Box 1133, Alton, NH 03809 603-875-3842 hshields@worldpath.net

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