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Referral patterns and diagnostic outcomes in an outpatient Australian tertiary cognitive neurology service: 2009-2019
Antony Sutherland1, Christopher Kyndt1,2, David Darby1,2,3,4,5
1Eastern Cognitive Disorders Clinic Box Hill Hospital Monash University Box Hill Victoria Australia.
Introduction:
Young-onset dementia (YOD) and atypical dementias often experience diagnostic delays, particularly in outpatient settings where timely referrals are crucial.
Methods:
A 10-year retrospective audit (2009-2019) of 626 patients at a specialist cognitive neurology clinic reviewed demographics, referral sources, and time to diagnosis. Data were compared between YOD and late-onset dementia (LOD), and with and without dementia groups.
Results:
Fifty-three percent of patients were diagnosed with dementia (mean age: 65 ± 11.9 years). Non-neurodegenerative conditions were more frequent in < 65 years (61%). Among YOD cases, Alzheimer's dementia (AD) and behavioral variant frontotemporal dementia accounted for 40% and 34% of diagnoses, respectively, while AD predominated in LOD (65%). Language-variant dementias were similar between groups (14%). Diagnostic delays in YOD averaged 1 year longer than in LOD.
Discussion:
Higher YOD and language-variant dementia referrals to specialist services reveal diagnostic delays, underscoring the need for better referral and diagnostic pathways.
Highlights:
Delayed diagnosis common in young-onset dementia (YOD) and atypical dementia.Specialist clinics see more YOD and language-variant dementia referrals.YOD has longer time from symptom onset to diagnosis compared to late-onset cases.Behavioral variant frontotemporal dementia (bvFTD) a more common diagnosis in YOD patients.