Recognition of preclinical signs of dementia: A qualitative study exploring the experiences of family carers and professional care assistants

Aims and objectivesTo identify preclinical signs of dementia by exploring the experiences of family caregivers and professional care assistants. BackgroundDementia results in disability, emotional strain and financial loss for people with dementia, family members and nations. Informal identification of social and behavioural risk signifiers could facilitate timely interventions with potential to delay onset of serious disability. DesignA retrospective qualitative approach using a naturalistic interpretive design was used. Focus groups enabled in-depth understanding of the participants' experiences of life or work with people who subsequently developed dementia. MethodsPurposive sampling was used to recruit family carers and professional carers who had cared for people who later developed dementia. The data from focus groups were fully transcribed and anonymised, and transcripts were analysed by two researchers. These researchers coded and analysed the transcripts independently; subsequently, overlapping and similar themes were identified and consensus reached on final themes. A third researcher was invited to review the analysis and ensure trustworthiness of the study findings. ResultsFindings revealed that preclinical signs of dementia were identifiable in retrospect Participants' accounts resulted in four themes, Lowered Threshold of Frustration, Insight and Coping Strategies, Early signs of poor memory and Alarming Events. ConclusionsEarlier recognition of preclinical signs of dementia would allow affected individuals to follow health promotion advice and plan for the future. Identification of social exclusion prior to diagnosis has implications for antistigma campaigns and development of dementia-friendly communities. Relevance to clinical practiceHealthcare professionals could work with those at risk, facilitating lifestyle changes to postpone symptoms and advance planning for improved autonomy. Predementia should be viewed as a disability for which reasonable adjustments can be made at a community level, to enhance and extend emotional well-being and social inclusion.