Transcript Patient Pathway for Dementia - Ipswich and East Suffolk CCG

Patient Pathway for Dementia
Dr Gillian Collighan
Patient Presentation
• From the community;
• Via self referral, or more commonly
through family
• From secondary care;
• Cognitive deficits highlighted via CQUIN
• Require six week check of cognition if
delirium has been evident
Cognitive Tests in Primary Care
• Test used depends on degree of
impairment
• AMT for moderate to severe impairment
• 6CIT for moderate impairment
• GPCOG for mild to moderate impairment
Mild Cognitive Impairment
• Some patients may present with poor daily
functioning without obvious cognitive
impairment on preceding tests
• Patients with frontal/executive dysfunction
can score well on memory tests
• MOCA / TYM test may pick up their
cognitive deficits
• Depression may cause/exacerbate
impaired cognitive function
Important information for effective
triage
• If impairment is severe, diagnosis could be
made at primary care level
• If behavioural problems present- will
require CMHT/ or crisis if acute and
severe
• Next of kin data is crucial
• Full medical history-as ACH inhibitors and
Memantine have systemic effects