Cognitive dementia and memory

Emergency and immediate referrals

Referral to Emergency Department

If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergency medical advice if in a remote region:

  • Sudden onset delirium or confusion with or without fever

Immediately contact the on-call registrar or service to arrange an immediate neurology assessment (seen within 7 days) for:

  • Rapidly progressing cognitive changes (over weeks)

To contact the relevant service, please see to HealthPathways: Acute Neurology Assessment

Presenting issues
  • Patients aged <65 years with ongoing, significant concerns regarding memory impairment, behavioural changes and/or concerns with executive function
Mandatory referral information (referral will be returned if this information is not included)

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)

If unable to attach reports, please include relevant information/findings in the body of the referral

Referrer to state reason if not able to include mandatory information in referral (e.g. patient unable to access test due to geographical location or financial cost)

Highly desirable referral information
  • 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.
Indicative triage category
Indicative triage 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
Excluded neurology services

Referral to public adult neurology outpatient services is not routinely accepted for the following conditions:

Condition Details (where applicable)
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 HealthPathways: Cognitive Impairment and Dementia
Last reviewed: 29-06-2023