The Humber Memory Assessment Service

1
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 MCs
  with.
• What, if any, impact has improved
  screening/awareness at primary care had on MC
  client group demographics.

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Identifier
4
Demographic changes
Clients 2014 (n417) 2015 (n416)
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 Carers Results 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 No Dementia No Dementia
MCI 8 4
No Dementia 10 14
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Analysis of demographics

• Negligible correlation between persons cognitive
  status and their affect. (r0.120, n319,
  p0.033).
• Negligible correlation between onset and
  depression or anxiety at assessment(r0.0117,
  p0.04).
• Moderate effect when caring for males carer
  more likely to be anxious and/or depressed and/or
  stress. (t2.124, p.034) (t3.407, p.001)
  (t2.743,p.006).
• Males tending to present with higher cognitive
  scores in clinic (t2.251, 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
PSI Profile Code 2014 2015
A 3 1
B 4 3
C 3 3
D 6 12
E 7 1
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.