Cognitive dementia and memory Referral Access Criteria

Referrers should use this page when referring patients to public adult neurology outpatient services for cognitive dementia and memory. 
Emergency referral
If any of the following are present or suspected, refer the patient to the emergency department or seek emergency medical advice if in a remote region.
  • Sudden onset delirium or confusion with or without fever
Immediate referral
Orange exclamation mark in triangle: orange alertImmediately contact on-call registrar or service to arrange immediate neurological assessment (seen within 7 days):
  • Rapidly progressing cognitive changes (over weeks)
To contact the relevant service, see Clinician Assist WA: Acute Neurology Assessment (external site)
Clinical indications for outpatient referral
If any of these issues are present, refer to outpatient services through the Central Referral Service (CRS).
  •  Patients aged <65 years with ongoing, significant concerns regarding memory impairment, behavioural changes and/or concerns with executive function.
Mandatory information
Referrals missing 'mandatory information' with no explanation provided may not be accepted by site. If 'mandatory information' is not included, the explanation must be provided in the body of the referral (e.g. patient unable to access test in regional or remote areas or due to financial reason).

This information is required to inform accurate and timely triage. If unable to attach reports, please include relevant information/findings in the body of the referral and advise where (provider) investigation/imaging was completed.

History
  • Relevant history, onset and duration of symptoms including:
    • Evolution of symptoms – progressive, stable or improving
  • Degree of functional impairment (e.g. impact on mobility/falls/employment/ADLs/weight loss/carer information)
Examination
  • Full neurological examination
  • Montreal Cognitive Assessment (MoCA) or MMSE cognitive screening will also be accepted
Investigations
  • Brain imaging and other relevant tests (include provider and date)             
Highly desirable
History
  •  Indicate whether the patient has previously attended a neurology clinic or seen a neurologist, geriatrician, psychiatrist, rehabilitation physician or any other specialist
    • If so please attach contact details, dates and any other information and correspondence relating to these visits           
Examination
  • Nil
Investigations
  • Nil
Indicative clinical urgency category

Category 1

Appointment within 30 days

  • Rapidly progressive cognitive change (over months) 

Category 2

Appointment within 90 days

  • All other cognitive change in younger patients aged <65 

Category 3

Appointment within 365 days

  • No defined category 3 criteria 
Exclusions
  • Cognitive impairment > 65 years old.
    • Refer to geriatric medicine or aged care as appropriate.
    • Patients whose primary and major diagnosis/symptomatology are alcohol, drug or psychiatry related, consider referral to alcohol and drug service or mental health service as first line.
    • See Clinician Assist WA: Cognitive Impairment and Dementia.
Useful information
  • Nil             

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Last reviewed: 29-06-2023