I have found myself under relentless pressure from a local GP to expand the diagnosis of Alzheimer’s disease to include people who do not meet established clinical criteria for dementia.
I spent a considerable amount of time examining the evidence behind current guidance which I was following and explained this to Dr Houston but he persisted to argue outwith evidence:
"My question was not whether this patient had dementia associated of Alzheimer's type but rather if he had Alzheimers disease so that we could give appropriate education and support to him and his family and possibly cognitive enhancers at an early stage as per current guidance."
I reminded Dr Houston that pharmacological options are licensed for the ‘treatment of mild to moderate dementia in Alzheimer’s disease.’ The SIGN and NICE guidelines are also for dementia.
I had previously sent Dr Houston currently available evidence that these drugs do not prevent the development of dementia. I also reiterated that the provision of support is not dependent on any diagnosis but determined by the needs of any individual patient.
This is the general situation in NHS Scotland six years later