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100 Years After Alzheimer: Contemporary Neurology Practice Assessment of Referrals for Dementia

Department of Medicine, Division of Neurology, University of Toronto, Department of Psychiatry, Division of Geriatric Psychiatry, University of Toronto, Baycrest Division of Neurology and Rotman Research Institute

Carin Binder, BSc, MBA

Janssen-Ortho, Inc, cbinder{at}its.jnj.com

Steven Smyth, MBA, MSc

Janssen-Ortho, Inc

Sharon Cohen, MD, FRCPC

Department of Medicine, Division of Neurology, University of Toronto, Toronto Memory Program Toronto, Ontario

Alain Robillard, MD, FRCPC

Hopital Maisonneuve Rosemont and University de Montreal Dept of Neurology, Montreal, Quebec Canada

Background: The prevalence of dementia is placing an increased burden on specialists.

Methods: Canadian neurologists responded to a structured questionnaire to assess reasons for referral and services provided as well as to compare the neurologists' perceptions of their practice characteristics against cases seen over a 3-month period.

Results: The audit confirmed the participants' perception that family practitioners are the main referral source (358/453, 79%). Sixty-two percent of patients had undergone clinical investigation for dementia prior to being seen by the neurologist; 39% (177/453) were on pharmacotherapy at the time of referral, 68% were initiated on pharmacotherapy by the neurologist. A fifth of the referrals did not meet clinical criteria for dementia, which may be directly related to the prevalence of prior workup that did not include mental status testing.

Conclusions: Neurologists currently treat patients referred for dementia who may already have been adequately evaluated and treated by primary care providers.

Key Words: Alzheimer's disease • dementia • specialist • referral and consultation • physician's practice patterns

American Journal of Alzheimer's Disease and Other Dementias®, Vol. 23, No. 6, 516-527 (2009)
DOI: 10.1177/1533317508328194


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