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Table 1 Model components

From: A new model for general practice-led, regional, community-based, memory clinics

The GP-led early detection and screening for cognitive impairment model addressed many of the barriers established in the literature, by including:

1. A locally-based education program for the GPs and PNs working in the multi-site practice, to develop their knowledge of the spectrum of cognitive impairment, the use of screening tests in the diagnosis of cognitive impairment (and associated depression), and the essential clinical examination, laboratory and radiological investigation required as a baseline prior to referral;

2. Integration of routine screening, using validated tools, within existing practice systems and software;

3. Cognitive screening by GPs and PNs of all patients over 65 years who attended the practice, as well as those younger people who were concerned (or the GPs concerned) about their cognition;

4. The professional staff of the Memory Clinic included a Consultant in Geriatric Medicine, and a Psycho-Geriatrician; This allowed easy access to specialist support without the patient needing to attend a tertiary care institution for further management;

5. Communication with the GPs and PNs after each assessment, including written report and if necessary a case conference with the GP and PN via telephone or video;

6. If deemed appropriate by the GP, people identified with either Mild Cognitive impairment or Dementia (referred to in ICD 11 as Minor and Major Neurocognitive Disorders) were reviewed by the geriatrician or psychogeriatrician as frequently, and for as long as considered necessary thereafter