I am looking for information regarding what different memory clinics do when they are presented with someone showing signs of subjective cognitive impairment (SCI). Specifically I am looking at people who present at a memory clinic complaining of a problem with their memory but no paper-based measures pick it up. These people will not have any objective cognitive impairment but know that something is not right. All clinics will look at possible alternative explanations for the SCI e.g. depression, but what I am interested in is what happens to that person when they cannot identify an alternative explanation. Some clinics operate an ‘open door policy’, thus they can contact the clinic for an appointment if they feel their impairment has worsened. Other clinics will discharge them from the service, and if their impairment worsens then they have to go back to their GP and be re-referred to the clinic. I welcome any additional thoughts or suggestions on this area.
Dear Amy,
Approximately one third of the population of our Dementia Service Centers are in the early stages of dementia (Auer et al, 2013). Persons with SCI are worried about their cognitive abilities and we should not send them away with an uncomfortable feeling- or worse telling them that everything is alright (even though they feel differently). We have developed a prevention training program that we offer to persons who would like to do something against their subjectively perceived loss of cognitive functions. In general a health psychological approach is suggested in which a healthy life style is promoted and persons get support to reach their new personal goals. Programs need to be developed and tested for efficacy
Dear Stefanie,
Thank you so very much for replying to my question, I really appreciate it. Your approach to people with SCI sounds excellent. I agree they should not be sent away being told 'nothing is wrong with you' because they obviously think/know otherwise. I believe that such a dismissal could potentially result in low mood and anxiety regarding their continuously identified symptoms. Thus, possibly giving rise to additional cognitive problems in relation to mental health problems. Would you mind me asking what is involved in the prevention training programme you offer please?
Dear Amy,
persons with SCI or GDS 2 after complete diagnostics receive a number of offers in our memory ambulance. They learn about risk reducing behavior like increased activity etc. They can participate in a self help group, can take part in groups with cognitive training or other content whenever they like. In some persons CBT is offered. Besides that persons have the chance to be followed in a 6-month rhythm or earlier when needed.
Dear Amy,
Our program is a global stimulation program consisting of cognitive tasks and physical exercise tasks. The prevention groups are lead by trainers (one year curriculum) and supervised by psychologists. The trainer needs to develop his program on the basis of the group's interests and abilities and increase the tasks complexities as the training progresses. As previously stated, the training program warrants efficacy study- participants stay in these groups sometimes for years especially for social reasons- but some say that they feel more confident about their cognitive abilities. In our program, persons are tested once every year after baseline.
Ralf and Stefanie, thank you so much for the information you have provided here, it is a huge help!
Dear Amy:
In our clinic , the age of the patient greatly conditions the follow up timing.
Presuming the neuropsicological testing results are similar, subjects in their 60's or less
are usually re-examined yearly. Dose over 60,biannually.
In every case patients are instructed that if they feel relatively fast worsening return as promptly as posible to the clinic
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