title: Open referral policy within a nurse-led memory clinic: patient demographics, assessment scores, and diagnostic profiles.
abstract: BACKGROUND
  Memory clinics, typically led by multidisciplinary teams and requiring health professional referral, are one means of providing diagnosis and care coordination for dementia. Nurse-led clinics may provide an effective and alternative means to dementia diagnosis, and open referral policies may minimize existing barriers to accessing a diagnosis, but evidence is needed.
  
  
  METHODS
  Patients attending a one-day per week nurse-led memory clinic over a 25-month period during 2011-2013 (n = 106) completed comprehensive cognitive assessments and were diagnosed by an aged care nurse practitioner. Descriptive statistics detail the demographics, assessment scores, and diagnostic profiles of patients. Comparable data from published literature was identified, and the differences were analyzed qualitatively.
  
  
  RESULTS
  One hundred and six patients were assessed with the key differences from other data sets being history of falls more common, higher mean Mini-Mental State Examination scores, and fewer dementia diagnoses. Sixty-four patients (60%) were self-referred to the nurse-led memory clinic, of which 19 (30%) were diagnosed with mild cognitive impairment (MCI) or dementia. Overall, forty-eight patients (45%) received diagnoses of MCI or dementia.
  
  
  CONCLUSIONS
  An open referral policy led to a high proportion of patients being self-referred, and nearly a third of these were diagnosed with cognitive impairment or dementia. Open referral policies and nurse-led services may overcome some of the barriers to early diagnosis that are currently experienced. Considering an aging population worldwide and the associated increases in cognitive impairment, which benefits from early identification and intervention, this paper provides an alternative model of nurse-led assessment.
authors.affiliation: Wicking Dementia Research and Education Centre,University of Tasmania,Hobart,Tasmania 7001,Australia.
authors.forename: Melinda
authors.initials: M
authors.lastname: Minstrell
authors.affiliation: Wicking Dementia Research and Education Centre,University of Tasmania,Hobart,Tasmania 7001,Australia.
authors.forename: Michael
authors.identifier: http://orcid.org/0000-0003-3016-6194
authors.initials: M
authors.lastname: Bentley
authors.affiliation: Department of Health and Human Services,Tasmania Older Persons Mental Health,90 Davey Street,Hobart,Tasmania 7000,Australia.
authors.forename: Hazel
authors.initials: H
authors.lastname: Bucher
authors.affiliation: Department of Health and Human Services,Tasmania Older Persons Mental Health,90 Davey Street,Hobart,Tasmania 7000,Australia.
authors.forename: Martin
authors.initials: M
authors.lastname: Morrissey
authors.affiliation: Wicking Dementia Research and Education Centre,University of Tasmania,Hobart,Tasmania 7001,Australia.
authors.forename: Carl
authors.initials: C
authors.lastname: Higgs
authors.affiliation: Wicking Dementia Research and Education Centre,University of Tasmania,Hobart,Tasmania 7001,Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Robinson
authors.affiliation: School of Health Sciences,University of Tasmania,Hobart,Tasmania 7000,Australia.
authors.forename: Christine
authors.initials: C
authors.lastname: Stirling
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D060825:Cognitive Dysfunction / Q000175:diagnosis / Q000451:nursing; D003704:Dementia / Q000175:diagnosis* / Q000451:nursing; D005260:Female; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000175:diagnosis / Q000451:nursing*; D008875:Middle Aged; D009483:Neuropsychological Tests; D009722:Nurse Practitioners; D012017:Referral and Consultation / Q000458:organization & administration* / Q000706:statistics & numerical data
keywords: dementia