Not all memory clinics are dementia clinics

A survey of case notes and correspondence from 200 consecutive attenders at a specialist memory clinic was conducted in order to assess the diagnoses, precipitants to referral, outcome, and placement at discharge. The mean age of the attenders was 43.7 years, and the diagnosis of dementia was much lower than in clinics in geriatric or psychogeriatric settings, arising in only 13% of patients. However, 56.5% of patients manifested either organic memory or more general cognitive impairment, progressive or nonprogressive, and a further 11% of patients exhibited either a ''frontal lobe'' or a dyslexic (reading disorder) syndrome. In addition, 10.5% of patients described either psychogenic amnesia or amnesia for an offence. Depression as a concomitant phenomenon was very common, arising in 40.5% of cases, and putative precipitants to the referral were identifiable in 54.5% of cases. The latter included failure to cope or problems at work (10.5%), marital or relationship problems (10%), and offences or compensation cases (14%). It is concluded that there is a place for memory clinics within adult (non-geriatric) neurological and neuropsychiatric services. In fact, they may be more necessary for young and middle-aged brain-damaged people, including those with psychiatric disorders compounding their amnesia, for whom assessment and rehabilitation services are often poor, than for elderly subjects with early dementia, for whom services are relatively well developed.