In a new research carried out at the University of Sheffield and Sheffield Teaching Hospitals NHS Foundation Trust, it was found that only half of patients seen at neurology-led memory clinics at the Royal Hallamshire Hospital suffered with dementia. Often patients are referred to the memory clinic not because they show sign of dementia, but because they are concerned about their memory.
Led by Markus Reuber, Professor of Clinical Neurology at the University of Sheffield and Honorary Consultant Neurologist at Sheffield Teaching Hospitals NHS Foundation Trust, this study is the first of its own kind.
For this particular study, the researchers used a method called ‘Conversation Analysis’ for the first time ever as a diagnostic tool for memory. In this method, audio or video recordings of talk between patients, carers and doctors are examined very closely. The research team studies the conversation closely to find out any subtle differences in the use of language. Such signs can be early symptoms of dementia. The research could help doctors in distinguishing people who are suffering from an early stage of dementia from those who only have memory concerns related to mood or anxiety-related problems.
In the UK, around 800,000 people have been diagnosed with dementia. It is believed that the number is conservative as there can be many others who remain undiagnosed particularly in the early stages. It has been estimated by the Alzheimer’s Society that the number of dementia sufferers is to increase to one million by 2021 and 1.7 million by 2051.
This research is significant because there are a high proportion of the people referred to the specialist memory clinic who do not to have any signs of dementia at present said Dr. Daniel Blackburn, Honorary Senior Lecturer at the University of Sheffield and Consultant Neurologist at Sheffield Teaching Hospitals NHS Foundation Trust.
About six years ago, one in every five patient referred to the clinic was found to have dementia. But, there has been an alarming increase in the rate of dementia sufferers. Today, almost every second patient referred is diagnosed with dementia. The results of the study would help GPs and other primary care health professionals to identify patients who need to be referred to specialist memory clinics. Additionally, it would help in minimizing the distress of patients who do not suffer with dementia while they seek support and reassurance for memory problems. It has been observed that patients who experience memory concerns but are unlikely to develop dementia often suffer with low mood, anxiety and depression. That leads to further memory problems. Such problems can be treated when identified with simple interventions like reassurance, talking treatments or medication for anxiety and depression.
Using the Conversational Analysis tool, video recordings were made of the patient’s initial visit to the memory clinic. The researchers focused on analyzing the opening conversation between the neurologist and the patient, and any family or friends who accompanied them. On close examination of the recordings it was found that there are two distinct conversational profiles: one for patients with dementia and the second for those who have memory concerns unrelated to dementia. Things that are crucial in segregating the profiles includes features like, who is most concerned about their memory (patient or family), patients’ ability to respond to complex questions, how they answers questions short or elaborate, repetitiveness and hesitancy in answering, etc.
The findings of the study will let doctors use their conversation with the patient as a kind of diagnostic tool where they look for any signs of memory loss or dementia.