The Cognitive Disorders Service runs in parallel with the Dementia Research Centre (DRC), part of the Department of Neurodegenerative Disease at the UCL Institute of Neurology (ION). The clinical and research components form a national centre of excellence for diagnosis and treatment of patients with cognitive problems, and the group is recognised internationally for ground-breaking research in dementia.
All forms of cognitive disorder are seen; however, we have particular expertise in young onset dementia, familial dementias and unusual degenerative diseases. Progressive disorders such as Alzheimer’s disease (AD), vascular dementia or frontotemporal dementia are commonly seen, but other less common disorders are also assessed including limbic encephalitis, hereditary leukodystrophies and acquired cognitive problems such as amnesia, aphasia, visuo-spatial problems, apraxia, facial recognition and executive dysfunction due to varying aetiologies.
The clinic has a national referral base and has agreed referral pathways with the local PCTs. Referrals are accepted from primary, secondary and tertiary care.
Patients are assessed in a consultant-led multidisciplinary clinic, including neurology, psychiatry, psychology, imaging, specialist nurse, neurophysiology and allied disciplines. Where appropriate, patients are investigated on the same day with MRI, EEG and psychology. If necessary they can be admitted for further investigations to the Day Case Unit at the NHNN and we have a dedicated lumbar puncture clinic for rapid access to spinal fluid assessment. This can be an important part of the diagnostic process. Other modalities of imaging are also available.
Ongoing communication is provided by the award-winning national CANDID (counselling and diagnosis in dementia) phone line and patient support groups in unusual forms of dementia e.g. posterior cortical atrophy, primary progressive aphasia and familial AD and FTD.
In addition to clinical care, all patients are offered the opportunity to participate in clinical trials and other studies at the DRC, which has major research commitments into early diagnosis and treatment of dementias. In addition the service has close links with DeNDRoN (Clinical Research network for Dementia and Neurodegenerative diseases) and the national director for dementia research is one of our consultants.
- Mild cognitive impairment
- Alzheimer's disease
- Primary progressive aphasia
- Semantic dementia
- Frontotemporal dementia
- Vascular dementia
- Dementia with Lewy bodies/Parkinson's disease plus dementia
- Progressive supranuclear palsy
- Corticobasal degeneration
- Epilepsy and dementia
- Limbic encephalitits
We see between 350-400 new patients per year for diagnosis and assessment.
We see approximately 850 follow-ups for therapeutic intervention, supportive management and ongoing assessment.
Due to high demand, the waiting time for new appointments is two to three months.
Counselling and Diagnosis in Dementia (CANDID)
Counselling and Diagnosis in Dementia is a nurse-led information and advice service, offering advice on how to access information on legal and financial matters and the role of statutory and voluntary support services.
The CANDID service, run by Katy Judd and Mandy Haines, is available to patients and families registered with the NHS specialist cognitive disorders clinic at the National Hospital, and associated healthcare professionals. It aims to enhance mutual understanding between patients and doctors through:
- face to face consultations at clinic appointments
- a telephone helpline service before first appointment, between appointments and following discharge to local services
- a nurse led therapeutics clinic
We also run a parallel nurse-led clinic for patients post-diagnosis.
In addition psycholgoical intervention is available for patients and their carers, where appropriate with Susie Henley, clinical psychologist.
Special interest groups
We run focus groups and support groups such as the PCA support group for patients and carers with posterior variant of disease and the PPA support group for those with primary progressive aphasia.
Following discharge patients are booked in to clinic to see their consultant for discussion of investigations and management. GPs and others involved in care are informed by letter or, if urgent, by telephone. Further care may be joint with the GP and service on ongoing within the community, dependent on the patient.