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Showing posts from July, 2017

#PreventiveNeurology: falling incidence of dementia

Will treating the whole population with the polypill reduce the incidence of all-cause dementia? #PreventiveNeurology

The falling incidence of dementia in England and Wales may be explained by cardiovascular risk modification and supports our ambition to test the polypill at a population level to reduce all-cause dementia. A falling incidence does not sort out the issue for the society and the government because the prevalence of dementia (number of people alive and living with dementia) is still increasing. There is also a very good podcast from the BMJ on the finding's. 

Ahmadi-Abhari et al. Temporal trend in dementia incidence since 2002 and projections for prevalence in England and Wales to 2040: modelling study. BMJ 2017;358:j2856

Objective: To forecast dementia prevalence with a dynamic modelling approach that integrates calendar trends in dementia incidence with those for mortality and cardiovascular disease.

Design Modelling study: Setting General adult population of England a…

#PreventiveNeurology: misdiagnosis needs a solution

How are we going to get the general population to sign-up for screening for neurodegenerative diseases? #PreventiveNeurology
Two of the three diseases we are targeting as part of our Preventive Neurology initiative will capture people with Diffuse Lewy Body (DLB) disease, i.e. Parkinson's disease and all-cause dementia. The BMJ commentary and DLB consensus report highlight the problem of misdiagnosis. If we are careful and embed in our prediction algorithms the right patient-related outcome measures and cognitive testing we should be able to identify a cohort of people with early DLB. May be this is wishful thinking. One of the obstacles we are going to find is getting members of the general population to sign-up for screening. Any ideas? 

Joseph Freer. UK lags far behind Europe on diagnosis of dementia with Lewy bodies. BMJ 2017;358:j3319


..... Around half of UK patients who have dementia with Lewy bodies (DLB)—about 60 000 people—have it misdiagnosed, usually as the far mo…