Hospitals miss dementia even when already diagnosed

Dementia is being missed by hospital doctors in four in ten cases, research shows.

The study by University College London found medical staff are routinely treating patients without realising that they had been diagnosed with dementia.

Researchers said the failure to properly record their illness meant vulnerable elderly people were being discharged from hospital with instructions to take crucial medication, without medics realising that they were likely to be suffering from memory problems.

They said too many pensioners were being admitted to hospital with physical health problems, without proper records being kept of other diagnoses like dementia which could affect them profoundly.

The research examined 138,455 hospital admissions from 21,387 people between 2008 and 2016, including 37,329 admissions of 8,246 people who had known dementia before general hospital admission.

Overall, hospitals recognised dementia in 63.3 per cent of inpatients who previously had a dementia diagnosis. Cases were more likely to be missed if patients did not have a partner and among those with severe physical illnesesses and those from ethnic minority backgrounds.

At the start of the study, in 2008, just 48.7 per cent of dementia cases were detected, with rates rising over the eight year period.

Dr Andrew Sommerlad, lead author

Researchers said the findings were likely to be an underestimate, as they only included cases where the patients had previously received a diagnosis.

Around 850,000 people in the UK are estimated to suffer from dementia, but one in three patients are undiagnosed. Researchers identified people who had been diagnosed with dementia in South London and Maudsley NHS Foundation Trust memory clinics, and subsequently admitted to a general hospital. The researchers examined whether dementia was one of the diagnoses on the patient's hospital discharge summary.

The study, published in Alzheimer's & Dementia: The Journal of the Alzheimer's Association, found dementia was almost twice as likely to be missed in those of ethnic minority backgrounds compared to white patients.

Lead author Dr Andrew Sommerlad (UCL Psychiatry) said better sharing of health records between health care providers could help reduce missed diagnoses and improve care for the vulnerable.

"People with dementia are more likely to be admitted to general hospitals for other illnesses, partly due to difficulties taking care of themselves - and once they're in hospital, those with dementia tend to have longer stays and face more complications.

“Hospital records need to accurately reflect the patient's condition so that doctors can tailor their care accordingly," he said.