Public Health Guidance to Facilitate Timely Diagnosis of Dementia: ALzheimer's COoperative Valuation in Europe Recommendations.

Objective: ALzheimer’s COoperative Valuation in Europe (ALCOVE) was a Joint Action co-financed by
the European Commission to produce a set of evidence-based recommendations for policymakers on
dementia. This paper reports on timely diagnosis.
Methods: Evidence was reviewed from scientific, policy and qualitative research. An online questionnaire
was completed by experts from 24 European Union countries detailing current practice. An iterative process
with people with dementia, family carers and professionals was utilised to develop recommendations.
Results: Advances in the technical aspects of diagnosis have changed what is understood by early
diagnosis. Although research into preclinical stages is crucial, diagnosing at these very earliest stages
is not recommended as regular practice. On balance, it is suggested that citizens should have access
to accurate diagnosis at a time in the disease process when it can be of most benefit to them. The term
timely diagnosis is used to reflect this. The diagnosis can help citizens and their families make sense of
what is happening and make lifestyle changes and plans for the future. The central principles identified
to maximise benefit and to reduce harm associated with diagnosis at an earlier stage included reducing
stigma about dementia; respecting the rights of the individual; recognising that how the diagnosis is
given will impact on subsequent adjustment and that post diagnostic support are required for the
person and their family. Detailed recommendations are provided for timely detection, the diagnostic
process, complex diagnoses, response to early cognitive changes and workforce.
Conclusions: The recommendations can be utilised at a local, national and European level to benchmark
progress.