How do memory clinics compare with traditional old age psychiatry services?

Methods 100 consecutive referrals to the Northern Memory Clinic (NMC) were compared with 100 referrals to a traditional Old Age Psychiatry (OAPsych) s ervice in the same city in terms of demographic variables, cognitive functi on (assessed by the Mini-Mental State Examination), and diagnosis. The stud y also examined the ability of psychometric assessments (CAMCOG, MMSE, Trai l-Making Tests A & B, Word Fluency) and CT scans included in the NMC assess ment to differentiate between those with and without DSM-IV dementia. Results NMC patients were significantly younger than OAPsych patients, had lower levels of cognitive impairment, and had a wider range of diagnoses. T he NMC patients who were diagnosed as having dementia were found to be at l east 2 years earlier in the course of the disease than those seen by the OA Psych team. The CAMCOG and MMSE were proved to be effective at distinguishi ng between patients diagnosed as dementing versus non-dementing with cut-of fs of 82/83 and 23/24 respectively, confirming previous findings. The Memor y subscale of the CAMCOG, though much shorter, was equally as effective usi ng a cut-off of 20/21. Trail-Making Tests, Word Fluency (FAS), and measurem ent of the minimum width of the medial temporal lobe (MTL) on angled CT sca ns were poor indicators of dementia in this sample. Conclusions This study confirms that the memory clinic is targeting a disti nct patient group compared to traditional old age psychiatry services, is i dentifying cases of dementia much earlier, and as such has potential to mak e valuable contributions to patient care. Copyright (C) 2001 John Wiley & S ons, Ltd.