The number of memory clinics for dementia assessment has increased substantially across Australia in recent years but neurologists are seldom involved in them, a new study shows.
A survey of memory clinics elicited responses from 90 services across the country, a number far higher than the nine services surveyed in a previous study in 2009, according to a report in BMJ Open.
However in contrast to other countries where neurologists are involved in running memory clinics, the clinicians responding to the survey on cognitive assessment services in Australia were predominantly geriatricians (43%) and neuropsychologists (23%), whereas only 7% of were neurologists.
And while staffing levels had improved slightly from 1.7 to 2.4 full-time equivalents since the previous national survey ten years ago , waiting times remained the same at around 10 weeks. Only 43% of clinics were able to achieve the benchmark wait time of six weeks.
Most referrals to memory clinics were from GPs, and only 8% were from neurologists.
The survey found that considerable variability in the funding structure, staffing and assessment procedures of memory clinics. Over 100 different cognitive assessment tools that were used, with screening tools such as MMSE and the clock drawing test being the most commonly used.
Almost all memory clinics (97%) offered follow-up assessments for their clients, but less than a third (31%) offered any form of cognitive intervention. The most common form of intervention reported was a combination of services provided by psychologists such as psychoeducation. The survey was unable to obtain detailed information on the use of other interventions for cognitive decline such as pharmacological and counselling therapies.
The study authors said the findings provided a useful snapshot of Australian memory clinics with baseline information that may be used as part of the move towards reducing the variability and gaps in dementia services in Australia.
Lead author Dr Inga Mehrani from the Centre for Healthy Brain Ageing, University of NSW, noted that there is now a national plan to standardise dementia assessment and treatment pathways and to improve the quality of diagnosis and care throughout the country via the Australian Dementia Network (ADNeT).
“ADNeT-Memory Clinics set out to establish a national network of clinicians and dementia care services to boost multidisciplinary collaboration, to harmonise diagnostic standards and develop clear pathways for post-diagnostic care and support,” she wrote.
“The survey results confirm the need for better resourcing of memory clinics and cognitive assessment services to further support early diagnosis of dementia and cognitive decline by increasing staff levels to match international standards,” she said.
“With projections of exponentially increasing numbers of people who will develop dementia in the next decades, it is essential that memory services are well equipped in terms of funding and best practices to provide early diagnosis and evidence-based post-diagnostic care.”