The diagnosis of dementia is too often a dialogue of the deaf. An older person starts to become forgetful but, when they take their fears to the family doctor, both parties have a vested interest in minimising the issue. The patient seeks reassurance. The GP is unwilling to proffer a diagnosis that could result in demands for expensive drugs that could delay the progress of the condition, especially when early diagnosis is notoriously tricky. Patient and doctor edge around the subject and eventually the doctor declares the belief that the patient's memory problems are "just part of growing old". The encounter ends with a handshake and smiles. It is only after much angst and several appointments that the patient is finally diagnosed and referred.

This must change. Simple demographics suggest that, barring some unforeseen medical breakthrough, the number of people in the UK with some form of dementia will swell from 700,000 to 1.7 million by 2051. Yesterday the Department of Health announced that every GP in England is to be trained to spot the early symptoms. There is also a plan to set up "memory clinics" where professionals can link with volunteers to offer treatment and support.

If devolution is to work, it must mean more than merely seeking Scottish solutions to Scottish problems. Sometimes it ought to mean England and Scotland following one another's leads, as it did for England with the smoking ban. The Scottish Government won plaudits from charities when it made the treatment of dementia a national priority. There have been several encouraging pilot projects but these have focused on post-diagnostic support. In Scotland, 4000 GPs are treating an estimated 62,000 people with dementia, including up to 1600 under 65. Each year another 6500 are diagnosed but, according to Alzheimer Scotland, others remain undiagnosed because family doctors lack the information and training to hazard a diagnosis. These patients may not only be missing out on treatments that could significantly slow their deterioration but are being robbed of the opportunity to structure future support for themselves. Meanwhile, they place increasing stress and anxiety on those caring for them. If the SNP administration is serious about giving priority to the treatment and care of dementia patients, that policy must start with the earliest possible diagnosis. In this instance, Scotland should follow England's lead.

Until we know more about conditions such as Alzheimer's and Parkinson's, diagnosis remains frustratingly imprecise. Yet the sums devoted to probing these conditions are tiny compared with cancer research. The same applies to treatment and care facilities. Part of the issue is the stigma that continues to hang around various forms of dementia, especially Alzheimer's. Until more of those living with these conditions are prepared to talk frankly about it, as the author Terry Pratchett has done, it will continue to be publicly ignored and privately feared.

Click here to comment on this story...