A - 100 Who Is at the Door? Clinical Presentations and Predictors of Dementia Diagnosis in a Specialist Dementia Service

Abstract Objective This service audit aimed to identify predictors associated with a dementia diagnosis and the diagnostic base rate in a UK-based, specialist Younger People with Dementia (YPWD) Service. Method All patients referred between July 2022 and 2023 to the YPWD service were included in the study. All 191 patients were under 65 years at the time of referral. 69 patients were excluded from analysis (e.g., if the patient withdrew from the service prior to assessment or if the referral was deemed inappropriate based on service guidelines). A quasi-experimental design was used, investigating the relative predictive value of factors such as demographics, presenting cognitive symptoms, comorbidities, or mental health to receiving a dementia diagnosis. Following definition, raters reviewed client case notes to establish the presence or absence of each criterion. Results Significant predictors of a dementia diagnosis in YPWD were functional change (p < 0.001), behavior change (p < 0.001), being accompanied to assessment (p < 0.001), diminished insight (p < 0.001), executive functioning difficulties (p < 0.05), cognitive screening test score below cut-off (p < 0.05) and previous radiological investigation prior to referral (p < 0.001). The diagnostic rate for YPWD was 15%. Conclusions Memory problems alone are an insufficient predictor for a dementia diagnosis in YPWD, unless accompanied by additional factors. Overreliance on the presence of subjective memory complaints in primary care as a percipient to referral for specialist assessment contributes to a low diagnostic rate for the service The presence of insight and attending appointments alone contraindicate the presence of an organic disorder. Results indicate that factors beyond diagnostic criteria may be clinically significant.