http://www.theguardian.com/society/2014 ... criticised

JHC, that presumably came from middle management or higher up. And then they signed off on it. Then enacted it. How did nobody say, 'WTF?!'

This is entirely politically driven. I remember a while back Mr Jeremy Hunt (we call him something else that rhymes with Hunt) saying we weren't diagnosing enough dementia. This is the result.

The problem with any screening programme is that it to meet a set of criteria (wilson's criteria)

1. the condition should be important
We know that dementia can be debilitating.

2. the progression of the condition should be understood
Well we don't really know enough about dementia for this to be true

3. there needs to be a stage where the disease is quiet or mild but is detectable
The disease can be mild but is usually undetectable in the early stages

4. should be able to easily test for it
Can't really do that with dementia. It's not like hypertension where if everyone had a blood pressure check, it would pick it up.

5. there should be a treatment for it
No effective treatment.

6. the treatment should be effective if started early
The problem is that the medication only really works in some people, some of the time

Thus screening for dementia is useless.

Paying a GP for diagnosis is wrong, both ethically and logically. The person who makes the diagnosis isn't the GP but the specialist. If I saw a patient with suspected dementia, I'd do bloods and a mental state exam. If I felt there was anything to warrant referral, they'd have an MRI whilst waiting to see the specialist. The specialist would then make the diagnosis. So why does the GP get paid?

I think there are a few cognitive function tests which are good indicators for likely onset of Dementia, but in general I agree. There seems little point to it...

"You're going to get dementia. We can't stop it, we probably can't treat it, it's going to get pretty bad. You'll probably not even be able to wipe your own arse before the end."
"Oh, wow, thanks."

I'm pretty sure I'd fail all of them these days.