Rising demand, robust triage? Service evaluation of the triage process in a young-onset dementia service

AIMS AND METHOD: To evaluate referrals to our local Young Onset Dementia Assessment Service (YODAS), analyse referral trends and re-referral patterns between 2020 and 2024, and review reasons for non-acceptance of referrals at triage. A retrospective review of electronic referral records was undertaken using descriptive analysis. RESULTS: Referrals to YODAS almost doubled over the study period, while non-acceptance rates remained relatively stable, rising from 52.6% in 2020 to 57.3% in 2024. Among 760 patients whose referrals were not accepted, the most common reasons for non-acceptance were: absence of features suggestive of neurodegeneration, cognitive symptoms better explained by mental health conditions, and insufficient referral information. Over one-quarter were re-referred, with two-thirds subsequently accepted. Only 6% of individuals whose referrals were initially not accepted later received a dementia diagnosis, indicating effective triage. CLINICAL IMPLICATIONS: A rise in the demand for dementia assessment from a younger patient population requires a careful triage to ensure the individuals with possible features of neurodegeneration are appropriately assessed, and cases where alternative explanations are more likely are directed to more appropriate pathways.