A comparison of memory clinics in London has revealed variation in the criteria for referring patients with suspected dementia, which researchers argue may contribute to delays in diagnosis. The article is published on Wednesday 9 November in the Journal of the Royal Society of Medicine.
Current National Institute for Health and Care Excellence (NICE) guidelines suggest that for patients with suspected dementia, GPs should first assess whether other medical conditions may be causing their symptoms, before referring them on to a specialist memory clinic for a diagnosis. This pre-referral assessment may typically involve tests of thinking and memory skills, as well as blood tests to rule out a range of other conditions.
Researchers from Imperial College London investigated the referral criteria set by seven different memory clinics in London, and found that the criteria varied from one clinic to another. While not all of the memory clinics required GPs to have carried out memory and thinking tests, some required extra assessments, such as a physical examination and further blood tests in addition to those recommended by NICE.
The authors argue that GPs may struggle to carry out all of these tests within standard 10-minute appointments slots, particularly when dealing with older patients who may have multiple health conditions. The researchers raise concerns that variation in memory clinics’ referral requirements may create unnecessary delays in people with dementia receiving a diagnosis. They suggest that these pressures could potentially be eased by changes such as the introduction of primary care-based memory clinics, or the ability for patients to be seen at existing memory clinics without a referral from a GP.
Dr Matthew Norton, Director of Policy at Alzheimer’s Research UK, said:
“It’s absolutely crucial that people with dementia should be able to get a timely diagnosis without delay. A diagnosis not only helps people to make sense of the symptoms they are experiencing, it opens the door for them to access existing treatments and support to help manage their condition.
“Many people with dementia tell us they struggled to get a diagnosis, and although there has been a welcome increase in the diagnosis rate, we should continue to seek improvements in the way a diagnosis is made. It would be helpful to explore whether alternative approaches could help ease pressures on NHS services, but diagnosing dementia can be a difficult and complex process. We must continue to invest in research to improve diagnostic tools if we are to simplify this process and help more people with dementia get a diagnosis.”