Journal of Alzheimers Disease & Parkinsonism
Open Access

Abstract

Introduction: The diagnosis of dementia is likely to be a protracted process, sometimes unnecessarily so. Delays from the point of initial recognition of a cognitive issue are often the result of either not recognizing the signs of early cognitive decline, a limited understanding of the benefits of timely diagnosis or delayed access to the next step in the diagnostic process. While research is ongoing, there is evidence to support the usefulness of a timely diagnosis of dementia. Aim: This project is specifically interested in local and international examples of service models which focus on reducing the time lag to diagnosis. Method: A review of the international literature including grey literature was conducted. Contact was made with service providers identified as carrying out relevant activities even if associated health service research had not already been completed for these activities. A scoping study in the State of Queensland, Australia was carried out to identify interactions between general practice clinics and memory clinics and what responses have been taken at a practical and unpublished level to improve access. Results: Computerized databases were searched resulting in 188 records after removal of duplicates. Following a formal systematic process, 21 papers were included in the final review. Four key strategies were identified for improving access to specialist assessment of dementia increasing the number of clinics across a wider geographic area; a mobile team where one specialist visits an individual in their home and completes the assessment; single point of referral for all patients in one regionaÃ?Â?Ã?Â?Ã?Â?Ã?Â? patient sent to the closest memory clinic or one with a shorter waiting list; specialists consult at the local general practitioneraAAÃ?Â?s clinic (GP). A representative from each of the 15 memory clinics in Queensland was interviewed. In some instances, specialists were unaware of the State health care policy and had not experienced any impact since its introduction. Waiting lists continue to be an issue but referrals are appropriate (borderline complex cases with a 50% diagnosis rate for dementia). Conclusion: Attention remains focused on community awareness of the differentiation between normal aging and cognitive issues and increasing GP awareness of benefits of timely diagnosis (early intervention to minimize negative outcomes). Support for general practice by improving links with specialistaAAÃ?Â?s memory clinics and removing geographical or physical barriers between GP clinics and memory clinics appear to be effective strategies to reduce delays in diagnosis.

Biography

Email: m.martinkhan@uq.edu.au