Co-developing a way for testing cognitive symptoms in primary care


BNSSG ICB Research Capability Funding­­.

What is the problem?

Dementia costs the UK economy £23 Billion a year, which may triple by 2040. This is more than heart disease, stroke and cancer. In England, the best estimate is that 676,000 people have dementia and there are 540,000 carers. A diagnosis of dementia is a key step in getting support for carers and wellbeing resources. GP referral patterns and diagnosis rates for dementia may differ for people in different ethnic backgrounds. Medicine for dementia can slow progression of symptoms and help people to stay independent and live at home.

It’s often easier to recognize the symptoms of possible dementia than to confirm the diagnosis. No single test is enough on its own. We’ve also noticed that standard tests don’t always take individual factors and symptoms into account. A diagnosis usually requires a structured history, cognitive test, information from a supporter, and test of everyday functioning. Which tests to use and package together depends on the individual and their symptoms. Patients often get a one size fits all approach, which may not test the persons difficulties.

We previously compared several tests in primary care to find which work well, and we are working on new technology that could help diagnosis in primary care. In this RCF and RFPB work we want to apply our findings of which tests work for who, and develop 2-3 packages of tests for primary care clinicians to use with patients, based on the symptoms and problems the patient has.

What is the aim of the research?

This study will co-develop a way for testing cognitive symptoms in primary care. This will help increase expertise in the diagnosis of dementia in the community, reduce dependence on key expert in hospital, and help make health and social care fairer.

How will this be achieved?

Our approach seeks to support current experts to continue to provide care, with a renewed focus on the most diagnostically challenging cases.

We will work with patients, supporters, clinicians, social care, and the third sector, building on existing networks, to co-produce a way of testing cognitive problems that a clinician could do in primary care, with the support of a GP for diagnosis and prescribing. We will assess cognition, information from supporters, and everyday function, to develop 2-3 “packages” of tests.  We will work with adults over 75 years, who are our target population, and especially with those of global majority or coastal communities.

The RCF Funding will support regular meetings with a partnership group to develop our ideas on a package of tests. Our partnership group will also help to develop and be involved as a co-applicant on the future RFPB application to trial the packages in practice.

Who is leading the research?

Dr Sam Creavin, NIHR Clinical Lecturer in General Practice, University of Bristol.

Further information

For more information or to get involved with this project, please contact