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Dementia Diagnosis and Monitoring Unit
The increase in life expectancy has provoked an increase in the number of elderly people in our society, putting dementia at the head of our public health problems. In the Autonomous Community of the Canary Islands, it is estimated that 25,000 people are affected by dementia, of which two thirds-- some 16,500 people-- suffer from Alzheimer's.
The Dementia Diagnosis and Monitoring Unit at Hospitales Universitarios San Roque in Las Palmas de Gran Canaria is a resource for people beginning to exhibit signs of dementia with the aim of providing early detection, and also for those suffering the clinical, functional and social consequences derived from this cognitive impairment, and for their families.
The clinical and research community both emphasize the importance of early detection and differential diagnosis of the disorders that give rise to dementia. Cognitive, affective and behavioural symptoms vary from one type of dementia to another and, consequently, so should treatments. Determining which type of dementia we are facing in order to adjust treatment of disease and maximize autonomy and quality of life of patients is, from this point of view, essential.
With respect to early detection, clinical experience highlights the importance of detecting states of dementia in their prodromal or early stages, so as to allow for ample enough time to apply pharmacological and non-pharmacological treatments to slow the progression of the disease; without forgetting important aspects such encouraging the patient and his or her caretakers to participate in decision-making with respect to the future.
Under these premises, in the Dementia Diagnosis and Monitoring Unit has established four broad objectives as the basis for action:
1) Providing etiologic diagnosis of dementia or similar cognitive impairments.
2) Proposing appropriate treatment as per the diagnosis provided, including pharmacological and non-pharmacological elements.
3) Offering psychological support to the patient and/or their caretaker.
4) Perform control and monitoring evaluations of the pathology and its treatment.
Moreover, among the specific actions performed are:
- A Neurology consultation, which includes making a record of the personal and family medical history of the patient, a physical and neurological examination and whatever additional tests the physician may deem necessary.
- A Neuropsychology consultation, which includes a detailed evaluation of the patient's overall psychological state and a cognitive, emotional and behavioural assessment. A comprehensive neuropsychological report is also provided.
- Neurology Consultation. A diagnosis is established after assessing the results obtained in additional tests and in the neuropsychological report. If no definitive diagnosis is reached, further follow-up visits are proposed in 6 to 12 months' time.
As far as actions to provide psychological support for the patient and his/her caretakers, the Neuropsychology Service offers clinical psychotherapy sessions aimed at helping them accept the disease, accompanying them in this final stage of life, and teaching techniques to manage stress and anxiety.
In order to monitor and control the disease, every 6/12 months the Neurology Services carries out a physical-neurological examination and clinical interview with the patient or his/her informants; the purpose of this is to assess the efficacy of the treatments recommended, make any adjustments deemed necessary, and estimate the need for further consultation with the Neuropsychologist.