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Brief info

Susan Kurrle is a geriatrician practising at Hornsby Ku-ring-gai Hospital in northern Sydney and at Batemans Bay and Moruya Hospitals in southern NSW. She is the Clinical Network Director for Rehabilitation and Aged Care in Northern Sydney Local Health District and she holds the Curran Chair in Health Care of Older People in the Faculty of Medicine and Health at the University of Sydney. Her research and practice interests centre on dementia and frailty, successful ageing, and improving care for older people in residential care including intergenerational care, and the use of volunteers in the management of behaviours and psychological symptoms of dementia.

Topic: Diagnostic Dilemmas with Dementia

This presentation reviews a number of cases which illustrate some of the diagnostic and communication dilemmas that clinicians experience in day to day practice in memory clinics.

With the possible advent of new therapeutic interventions for Alzheimer’s disease, there is increasing emphasis on detecting and diagnosing cases of probable disease at a pre-symptomatic or very early stage of dementia. This has led to a number of people with subjective memory complaints being given a diagnosis of mild cognitive impairment or Alzheimer’s disease, often in the absence of strong evidence. Often the patients are referred for inclusion in a clinical trial, but do not meet MCI or dementia inclusion criteria. Managing these patients who have often made major life changes on the basis of the diagnosis can be challenging. Another important area is communicating the diagnosis of dementia, and doing this in a sensitive and appropriate way with input from family members and others. A third area where concerns have been raised by clinicians is in the ‘commercialisation’ of dementia with patients spending up to $5000 in out of pocket expenses for investigations to confirm the diagnosis of dementia.