BMJ 2013;347:f6704 doi: 10.1136/bmj.f6704 (Published 12 November 2013)

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Letters

LETTERS SCREENING FOR PRE-DEMENTIA

Dementia statistic is misleading Martin D Brunet general practitioner Binscombe Medical Centre, Godalming GU7 3PR, UK

In their responses to Le Couteur and colleagues’ article, Burns and colleagues state that fewer than half of people with dementia receive a formal diagnosis.1 2 This commonly quoted claim is a misleading use of questionable prevalence data and needs to be challenged.

The statistic they refer to is an estimate that currently 46% of those with dementia in the UK have received a diagnosis.3 It is based on extrapolation of 20 year old data by a Delphi consensus group that met in 2007,4 and more recent research suggests that the prevalence of dementia is much lower than thought, so diagnosis rates are higher than this estimate.5 However, even if 46% is correct, it is misleading to state that fewer than half of people receive a diagnosis. Even if 54% of people with dementia in the UK are as yet undiagnosed, this does not mean that they will never receive a diagnosis, as Burns and colleagues imply. This misinterpretation of such an important statistic in the debate around the diagnosis of dementia is unhelpful and needs to be corrected.

Competing interests: I have received income for writing and speaking from Pulse, and income for writing from Prescriber. 1

2 3 4 5

Burns A, Alessi C, Banerjee S, Bateman D, Bayliss-Pratt L, Brindle P, et al. Too much medicine: dementia [rapid response to: Le Couteur DG, et al. Political drive to screen for pre-dementia: not evidence based and ignores the harms of diagnosis]. BMJ 2013 www. bmj.com/content/347/bmj.f5125/rr/664725. Burns A. Alistair Burns and 51 colleagues reply to David Le Couteur and colleagues. BMJ 2013;347:f6125. (15 October.) Alzheimer’s Society. Dramatic variation in dementia diagnosis across UK. 2013. www. alzheimers.org.uk/site/scripts/news_article.php?newsID=1463. Knapp M, Prince M. Dementia UK. Full report into prevalence and cost of dementia. Alzheimer’s Society, 2007. www.alzheimers.org.uk/site/scripts/download.php?fileID=2. Matthews FE, Matthews FE, Arthur A, Barnes LE, Bond J, Jagger C, Robinson L, et al. A two-decade comparison of prevalence of dementia in individuals aged 65 years and older from three geographical areas of England: results of the Cognitive Function and Ageing Study I and II. Lancet 2013; published online 17 Jul.

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