Views & Reviews From the Frontline

Bad medicine: dementia

BMJ 2012; 344 doi: (Published 01 June 2012) Cite this as: BMJ 2012;344:e3859

Re: Bad medicine: dementia

I was disappointed to read Des Spence's article in the BMJ on the 9th June.I am a Retired Psychiatrist for Older Adults and was diagnosed with very early onset vascular dementia in 2005.

My experience as a professional is that people want to know what is causing their symptoms, whether these may be Cancer or Dementia. I was certainly relieved to know there was a cause for my symptoms, in my case treated by more effective control of my blood pressure. However I had no follow-up for three and a half years during which I thought it was not progressing but without further tests I could not be sure that I did not have a mixed pathology with Alzheimer's disease.

The article refers to 'big pharma' but many people with dementia cannot take the pills and they are not effective in all types of dementia. Dignosis is not to ascertain simply that there are cognitive changes but also to try to ascertain the type of dementia of which there are many. Older age may be a risk factor but dementia, especially rarer forms of Alzheimer's Disease, Lewy Body Disease and vascular disease (not necessarily stroke)occur in the decades before 60 and the implications of late diagnosis when the person is the wage earner in a family with children can be very difficult.

Treatment in the broadest sense is invaluable to all those with an early diagnosis as they can prepare with their families for the likely progress of the illness. They can learn about the help that maintaining activities and even learning new ones can bring. And, very importantly, carers can get the essential advice and help that will support them before a crisis is reached and this can usually prevent such a situation. There are many of us with an early diagnosis who are able to talk about these things, I suggest that Des Spence tries to meet some of us.

Competing interests: Person with a diagnosis of early dementia

15 June 2012
Daphne R. Wallace
Alzheimer's Society
15 Holme Park, Bentham, Lancaster LA2 7ND