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Has the referral of older adults with dementia changed since the availability of acetylcholinesterase inhibitors and the NICE guidelines?

Old Age Psychiatry, Older Peoples’Mental Health Service, Box 311, OPMHS Office, Fulbourn Hospital, Cambridge CB15EF, e-mail: c.oloughlin{at}btinternet.com

Jon Darley, Consultant

Old Age Psychiatry, West Suffolk Hospital, Bury St Edmunds

Declaration of interest

None.

AIMS AND METHOD

To investigate whether patients with dementia are referred to specialist services earlier in the disease since the launch of acetylcholinesterase inhibitors and the publication of the National Institute for Clinical Excellence (NICE) guidelines for the use of these drugs. All referrals to old age psychiatry services in two 6-month periods in 1996 and 2003 were surveyed retrospectively for diagnosis, Mini-Mental State Examination (MMSE) score and use of acetylcholinesterase inhibitors.

RESULTS

The mean MMSE score at referral increased from 18.8 to 21.5 (P=0.0005) between 1996 and 2003. Acetylcholinesterase inhibitors were prescribed for 35% of all patients and 58% of patients that would be suitable according to NICE guidelines in the 2003 group.

CLINICAL IMPLICATIONS

The earlier referral of patients with dementia to mental health services is encouraging.

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