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The Humber Memory Assessment Service
Dr Chris Rewston (Clin.Psych) and Gemma Forshaw
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Aims of this presentation
To discuss the demographics of people who use Humber Memory Clinic. What difficulties and needs do people enter MC’s with. What, if any, impact has improved screening/awareness at primary care had on MC client group demographics.
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Identifier %
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Demographic changes Clients 2014 (n=417) 2015 (n=416) Age (years)
80 (53-95) 82 (52-101) Onset (years) 3.0 (0.3-15) 2.3 (0.3-12) ACR-III 61 (0-94) 62 (18-89) Client Anxiety 5 (0-19) 3 (0-20) Client Depression 4 (0-17) 2 (0-16) Carers Results Carer Anxiety 6 (0-20) 5 (0-25) Carer Depression 4 (0-17) 3 (0-18) Relatives Stress Scale 16 (0-57) 14 (0-49) No Dementia MCI 8% 4% 10% 14%
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Analysis of demographics
Negligible correlation between person’s cognitive status and their affect. (r=0.120, n=319, p=0.033). Negligible correlation between onset and depression or anxiety at assessment(r=0.0117, p=0.04). Moderate effect when caring for males : carer more likely to be anxious and/or depressed and/or stress. (t=2.124, p=.034) (t3.407, p=.001); (t=2.743,p=.006). Males tending to present with higher cognitive scores in clinic (t=2.251, p=.025).
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Interventions Individual Psychoeducation Social Stimulation
Cognitive Rehabilitation Assertive Engagement Case Management Post Diagnostic Support Cognitive Stimulation Therapy (CST) Individual Cognitive Stimulation Therapy (iCST) Carer Psychotherapy Support/CBT Carer Life Story Work Strategies for Relatives (START) Dementia Advisors (Alzheimer's Society).
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Profiles A* 3 1 B* 4 C* D* 6 12 E 7 F 9 2 G 22 25 H** 46 52 *Summary
PSI Profile Code 2014 % 2015 A* 3 1 B* 4 C* D* 6 12 E 7 F 9 2 G 22 25 H** 46 52 *Summary Higher complexity indicated cases (A, B, C, D) = of those formulated 16% (2014) 19% (2015). **H profile (Lowest intensity of need/support) make up 46% (2014) and 52% (2015) of those formulated.
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Summary Positive changes: Good evidence of earlier detection.
Increase in GP initiated referrals (4th to 1st). Drop in the number of people with dementia presenting with comorbid anxiety/depression (improved public awareness/ consultations?). Increase of assessing profiles previously reluctant to engage with services. Areas for possible attention: Carer challenged profiles remain largely unchanged. Males with memory difficulties linked to more carer need. Males tend to present with high cognitive status.
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