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	TX: 29.05.08 - Memory Clinic PRESENTER: LIZ BARCLAY

	Downloaded from www.bbc.co.uk/radio4 THE ATTACHED TRANSCRIPT WAS TYPED FROM A RECORDING AND NOT COPIED FROM AN ORIGINAL SCRIPT. BECAUSE OF THE RISK OF MISHEARING AND THE DIFFICULTY IN SOME CASES OF IDENTIFYING INDIVIDUAL SPEAKERS, THE 麻豆约拍 CANNOT VOUCH FOR ITS COMPLETE ACCURACY. BARCLAY Now how do you know if your memory is going or whether you're just having an off day and forgetting the odd thing or two? This morning the Alzheimer's Society and the Department of Health are launching an awareness campaign called Worried About Your Memory, to help people recognise the onset of dementia so that they can get practical and emotional support early. Our disability reporter Carolyn Atkinson is here. Carolyn, what are they doing? ATKINSON Well they're basically doing two things: They're targeting us the public and GPs to try to spot the symptoms of dementia much sooner and to bring dementia out of the shadows as it were. Now if you go into your GP's surgery in England you should find some leaflets, some booklets, some posters all offering advice on what to look for and what to do if you or a relative are worried about your memory. And GPs themselves are going to be getting a CD-Rom to train them to spot things earlier and that should go down very well because according to the National Audit Office at the moment only 30% of GPs feel they actually have enough basic information and training to diagnose people and then to manage those people when they've been diagnosed with dementia. BARCLAY How bad are things at the moment then to warrant spending half a million pounds on this campaign? ATKINSON Well according to the Alzheimer's Society two-thirds of people with dementia never get a diagnosis because either they don't spot what's going on, they don't tell their GP and currently if people do get diagnosed it takes an average of three years to get that diagnosis which means many people are missing out very early on with early practical and emotional support and that could be things like setting up a lasting power of attorney or a living will, discussing things with your family about your future care, what you want to happen. The one thing it won't mean though, getting an early diagnosis, is it won't mean getting any access to drugs because at the moment the anti-dementia drugs are only available to people with moderate symptoms, not with mild symptoms. Of course the overall picture about this is that as we all live longer more or us are going to get dementia because the biggest risk factor in all of this is age and at the moment one in six people over the age of 80 will develop it. BARCLAY In 2005 we broadcast a number of reports about dementia and you visited a memory clinic to find out what support is available. ATKINSON Yeah, well there are about a hundred memory clinics across the UK and that is where your GP is likely to send you if they do suspect that you have dementia. I visited Dr Clive Holmes who runs the memory clinic at Moorgreen Hospital in Southampton, where he assesses and he diagnoses people like Edith Walters who's cared for by her husband Bill. BILL We met during the war, about 1940 wasn't it? EDITH Can't remember love. BILL Do you want me to help you? EDITH Yes. BILL You'd been over to the fish and chip shop hadn't you and you were walking back home and I was on the corner with a couple of my mates. EDITH And I picked him up. HOLMES Well this lady who's been seeing me for a little while now, we're just doing a reassessment to see how she's getting on, I'm following her up on a six monthly basis, and she's been started on a drug for Alzheimer's Disease and we're just seeing how she gets on. BILL We've had some rough times but we haven't done too bad have we love? HOLMES Can you remind me Mr Walters how long has it been since Edith had a problem with her memory? BILL It's about year 2000 wasn't it but we reckon she had it 18 months before that. You take the washing up - she's had to ask me where the different crocks and pans have got to go. We've been in the house for 60 years, it hasn't altered much since we've been there. HOLMES What I'm going to do now, Edith, I'm just going to ask you a few of these daft questions to see how you're getting on, is that okay and we'll see how you go? ... Okay alright. BILL Don't let him see that I've wrote the answers on the back of your hand will you. HOLMES Can you tell me what year it is at the moment Edith, what year is it? EDITH Not really. HOLMES Not sure? EDITH Nineteen twenty something is it. HOLMES Nineteen twenty, okay. Can you tell me what month is it at the moment, what month is it? EDITH January. HOLMES January, okay. The general process in dementia is essentially the same, for all dementias there's basically a loss of nerve cells throughout the whole of the brain. The disease in its early stages does seem relatively benign, major problems are really of short term memory loss. But it has to be said as the disease progresses it's actually quite an horrendous neurological disease for some patients. People with Alzheimer's lose their very self I think and they become lost in a world of their own, they don't know what's going on around them and they lose their dignity, they lose control over their own lives. And that's why I think it's just so important for us just to try to get some new treatments, more research, in this area to prevent from this happening to so many people. What I'm going to do now I'm going to ask you to remember three objects for me, okay? Ready? Apple, table and penny. EDITH Apple, table and penny. HOLMES Okay. Now I want you to remember them because I'm going to ask you them in a few moments time, okay? Apple, table, penny. Okay? In the meantime can you spell the word world for me? EDITH W o r l d. HOLMES Excellent. Now can you spell world backwards for me now? EDITH D l o o w. HOLMES Okay well done. ATKINSON When someone turns up for the very first time can you give some examples of the types of tests you would do that would begin to signal to you that there is a possible diagnosis? HOLMES The fundamental thing is we take a history and that takes quite a long period of time. And then following a history we usually examine the patient physically, just to check if there are any neurological signs or symptoms. And then following that mini mental state examination which assesses a number of different things - it measures memory, of course, but it's not just about memory; we'll do a number of tests which will measure the ability of a person to remember words, also to do simple calculations also to do paper tests which will test their visual spatial ability - to be able to copy objects. So it's a mixture of tests which measures different areas of the brain function. Now I asked you to remember three objects, do you remember? Can you remember what they were? Not sure? EDITH Was it the day? HOLMES No, I said I want you to remember three objects for me. Apple was one. EDITH Oh yeah. HOLMES Do you remember the other two? EDITH Was it pear? HOLMES No. Apple. EDITH Peach? HOLMES No. Apple, table. EDITH And chair. HOLMES Penny it was, penny. Not to worry, okay. ATKKINSON Romola Bucks, you're a neuropsychologist here at the memory clinic, when Dr Holmes has patients who he's not sort of black and white about, not 100% sure that there is or isn't a dementia beginning, he will pass on to you, so what is your role? BUCKS My role is to help to explore whether or not there is a subtle difficulty present that Dr Holmes' screening tools aren't picking up. Dr Holmes asked Mrs Walter's to repeat three words to him, those were apple, table, penny and for many people that would be sufficient because they would have difficulty with just three words. Within an unclear case, the kind referred to me, I would be using a more challenging memory task, for example, a story recall task. So I would ask the individual to repeat a short story to me. If you like we can have a go. ATKINSON Okay. BUCKS Okay. I want you to listen carefully and when I've finished tell me as much of it as you can remember. Are you ready? ATKINSON I am ready. BUCKS Mrs Joanne Smith had a car accident on Friday in the car park at the supermarket. She broke the eggs in her basket but nobody was injured in the accident. However, her husband had to eat toast for his tea as there were no eggs for the omelette. Off you go. ATKINSON Okay. Okay. So Mrs Joanne Smith was in the supermarket car park and she had an accident. Nobody was injured in the accident but she did break the eggs. So her husband had to have toast for tea because she wasn't able to make an omelette. BUCKS That's great. We don't expect exactly the same words, it's the gist we're looking for. Now we then say to the person please remember that because I'm going to come back and ask you to retell me the story later. ATKINSON What would you have to have forgotten to make you start wondering if there is a problem? BUCKS Occasional forgetfulness is normal, being tired and getting the words mixed up or forgetting the oldd part or maybe a little bit of the middle of it is normal. What isn't normal is not remembering that I told you a story at all or hardly being able to get any details at all, even after a short delay of about 20 minutes. HOLMES Can you write me a sentence along there, anything at all, as long as it's not rude I guess. Brilliant. Okay, well done, that's excellent. Right. BILL What did she write in her sentence? HOLMES Yes she wrote thanks for everything. EDITH I think go careful because he's got two of us against him. HOLMES Okay I think that's all I wanted to do today. You seem to be doing pretty good to me, yeah seem to be holding your own. Today Edith scored 20 points out of a possible score of 30 points. And that's exactly the same score she scored five years ago when I first saw here. I mean to give an example - an average decline would be about two points a year, so I would be expecting her really to be scoring more like 10 points now and yet here she is scoring 20, she hasn't changed. So it gives you an idea that really she does seem to me clinically to be showing some benefit. Anyway you take care you pair, thanks very much for coming. EDITH Thank you for what you've done. HOLMES You're welcome. BARCLAY Dr Clive Holmes from Moorgreen Hospital in Southampton. And Edith is still doing well and will be 85 on Monday. So Carolyn, what sort of symptoms should we have checked out? ATKINSON Well according to the Alzheimer's Society it's things like if you're struggling to remember recent events but you can easily recall things that happened in the past. Or another example: if you find it hard to follow conversations or programmes on television, if you're regularly forgetting the names of friends or everyday objects. And if you're repeating yourself in conversations or losing the thread of what you're saying and making it hard to make decisions - those could mean something's up but of course that won't always mean there's some dementia going on. But what the Department of Health and the Alzheimer's Society is saying if you're in doubt have it checked out. BARCLAY Thanks. And you can find out more by going to our website where you can hear all our previous reports about dementia or read the transcripts and with the carers and dementia strategies due soon from the government please do let us know of your own experience Back to the Transcripts homepage Back to the You and Yours homepage The 麻豆约拍 is not responsible for external websites

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