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It
is important to diagnose the type of dementia as accurately and
as early as possible, in order to provide individuals & their
families with comprehensive information, and access to appropriate
support & treatment. As younger people with dementia are an
extremely hetrogeneous population, and the impact on the individuals
and families is profound, specialist assessment is deemed essential
(Department of Health 2001). Assessment needs to be accurate, comprehensive,
multidisciplinary and co-ordinated (Alzheimer's Disease Society
1991,1995; Cox 1991), but the experience of individuals and carers
is often one of 'Falling through the net' (Cox 1991, p. 76)
In the absense of
a clear care pathway and established protocols between primary and
secondary care, younger people with dementia, their families and
general practitioners access specialist assessment and diagnosis
via different routes (Cox 1999; Clarke 2000). Clinical diagnosis
is a core component in assessment, but reasearch shows that this
may be made by many different specialisms, including adult psychiatry
and neurology (Allen & Baldwin 1995). More recently the Royal
College of Phychiatrists (1999) has established a position statement
that makes the case for diagnosis to be undertaken by a consultant,
based in old-age psychiatry but specializing in younger people,
who would be able to draw on the department's resources and expertise
related to dementia, and manage clinical care more appropriately
Assessment usually
includes a detailed individual & family history, magnetic resonance
imaging scans, blood tests, electroencephalograms, neuropsychological
tests, lumbar punctures and very occassionally a brain biopsy.
This extract is reproduced
with kind permission of Maria Parsons from her excellent chapter
11 in the book entitled Dementia Care by Trevor Adams & Jill
Manthorpe (2002)
An MMSE (Mini-Mental
Status Examination), will also be conducted, and repeated to determine
the diseases advancement
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