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 recognising 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interactions between general practice clinics and memory clinics and what responses have been taken at a practical, and unpublished, level to improve access.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: Computerised 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 regionpatient sent to the closest memory clinic or one with a shorter waiting list; specialists consult at the local general practitioner�s clinic (GP). 53 general practitioners were surveyed across the 11 State Medicare local districts. A representative from each of the 15 memory clinics in Queensland was also interviewed. In some instances, doctors were unaware of the State health care policy and had not experienced any impact since its introduction. Those doctors in more remote areas reported evidence of improved access to diagnostic support following the introduction of the policy. Significance: Early/timely diagnosis of dementia is often overlooked as an opportunity for change, given the challenges associated with prevention, treatment and/or cure. This project summarises approaches taken around the world for improving access to timely diagnosis of dementia.

Biography

Melinda Martin Khan PhD is a Research Fellow at the Centre for Research in Geriatric Medicine at The University of Queensland School of Medicine, Australia.