A multidisciplinary memory clinic in a neurological setting: diagnostic evaluation of 400 consecutive patients

This report describes the operation of a multidisciplinary university hospi tal memory clinic in a neurological setting, and the diagnostic evaluations in 400 consecutive patients referred for cognitive symptoms and possible d ementia during a period of 27 months (1 September 1995-31 December 1997). T he mean age of the patients was 63.6 years (range 19-97), On clinical and n europsychological examination, 46% of the patients fulfilled DSM IV criteri a for dementia, 5% had selective amnesia, and 14% had other selective cogni tive deficits. The remaining patients had either no significant cognitive d eficits (31%) or were not evaluable (4%). A wide range of disorders from th e fields of neurology, psychiatry neurosurgery and internal medicine were i dentified as the underlying etiologies for the cognitive symptoms. Potentia lly reversible conditions were observed in 26% of the patients, not includi ng the 11% in whom no specific underlying disease was identified. Concomita nt conditions or risk factors with a potential influence on cognitive funct ions were identified in 61% of the patients. Diagnostic evaluation of patie nts with mild to moderate cognitive symptoms and possible dementia is an in tegrated multidisciplinary task, which should focus on the identification o f non-progressive and potentially reversible etiologies, co-morbidity, sele ctive cognitive deficits, and rare or atypical neurological conditions, as well as on the early identification of common progressive dementia disorder s. Eur J Neurol 6:279-288 (C) 1999 Lippincott Williams & Wilkins.