Memory services, or memory assessment services, are sometimes referred to as a memory clinic. Here we explain what a memory clinic is, who you can expect to see, what happens during appointments and what happens afterwards.
The memory clinic
The memory clinic is run by a selection of different medical professionals in your area. There will be consultant doctors as well as occupational therapists, specialist nurses, and psychologists.
They run comprehensive assessments on the cognitive function of people of any age presenting with memory problems. Their role is to understand the cause of the memory loss and potentially make a diagnosis, such as dementia.
Beyond assessment and diagnosis, the memory clinic remains a central part of the support structure around someone with memory difficulties. They are a source of information for both the individual and their carers and loved ones. They can support adjustment to a diagnosis and teach and share strategies and treatments to enable the best quality of life in individuals with memory issues.
Why have I been referred to the memory clinic?
People experience memory problems for all kinds of different reasons. It may simply be part of the ageing process, but it could also be caused by something else, such as Alzheimer’s disease, or even stress. The purpose of attending the clinic is to work out what’s causing your memory loss, how significant it is, and provide support and treatment.
You will have been referred to the clinic if you’ve had concerns about your memory, or a friend, relative or other medical practitioner has expressed concerns.
What happens at a memory clinic?
The first visit to a memory clinic will usually be an assessment. You’ll likely be attending because you have begun to experience difficulties with your memory, or with thinking and doing things such as following your everyday routines and forgetting common words.
It is very common to have blood tests either before you go to memory clinic, or as part of the assessment. This is because there are some causes of memory problems, such as low vitamin levels, which are easy to spot and easy to reverse.
The first step then is to undergo a Neuropsychology Assessment. These are a series of memory tests which are usually carried out by a specialist nurse or psychologist. It’s common at the first appointment that you’ll have these tests done by the psychologist.
The memory tests are very detailed and can take up to a couple of hours to complete.
What memory tests are done at memory clinic?
The purpose of the tests you’ll undergo are to determine brain function (referred to as cognitive function). With dementia, for example, certain areas of the brain are more typically affected early on. Most specifically, short-term memory recall can be a concern and so this is more easily picked up in these memory tests.
The tests are designed to identify the different functioning levels of different areas of the brain. This is because impairment in different areas will affect you differently. For example, a problem in the temporal lobe may cause problems with recognising names and faces, or difficulty understanding when someone talks to you, whereas a problem in the frontal lobe may cause problems with sequencing, problem solving or behaviour.
There are some common tests which will be done during your memory clinic assessment. These include:
- Addenbrooke’s Cognitive Examination: A general assessment covering most of the brain’s functioning.
- Test of Premorbid Functioning (TOPF): This test is used to determine your previous functioning based on your background. This is so that changes and deterioration can be spotted against your own unique baseline.
- Motor Speed: Tests how fast you can process different things.
- Attentional Capacity: Looks at your ability to focus and stay on task.
- Objection perception/Visuo-spatial functioning: Using pictures and drawing, this assesses your brain’s functioning in terms of the information from visual cues.
- Language: Determines your ability to use and understand language.
- Executive functioning: Tests your ability to follow tasks and processes, including your cognitive flexibility (the ability to change attention, if needed, during a task).
For each area of testing, the practitioner will summarise your results. This will determine if your memory functioning in each area is average, low or high, depending on your background.
What else happens at a memory clinic assessment
The assessment isn’t limited to tests alone. Alongside the tests, the psychologist will want to learn more about your daily functioning. You may hear the term ‘ADLs’ here. This stands for ‘activities of daily functioning’. This means that you’ll be asked questions about the things that happen in a usual day, such as getting washed and dressed, making your meals or undertaking social events. They will want to understand your medical history to understand the pattern of your memory loss too.
You can also expect to be asked questions which are used to determine your mental health. They may use common tests such as the Patient Health Questionnaire (PHQ) or Generalised Anxiety Disorder Scale (GDS) which are a simple list of phrases which you score yourself against. These are to screen for disorders such as anxiety and depression. It is very common for memory problems to either be caused by, or be a consequence of, mental health problems.
Furthermore, it is usual at a memory clinic for an MRI or CT scan of the brain to be organised. This will usually be carried out at a different time. The purpose of the scan is to look at the blood supply to the brain and spot any visible damage or areas of concern. Some areas of the brain are specifically affected by different conditions so this can aid diagnosis.
Meeting with the consultant
Once you’ve been through the tests, discussions, history-taking and scans, you will then usually meet the consultant psychiatrist at the memory clinic. These psychiatrists specialise in the diagnosis of conditions such as dementia. They too may repeat some of the questions and history-taking. This is quite normal.
It is also very usual for the psychiatrist to speak with a family member or close friend for their description of the problems you’ve been having, with your consent. There’s even a term for this – collateral history – and it’s a really important part of helping with your diagnosis and care.
The consultant will then talk to you about the results of the brain scan and the tests and share any diagnosis they’ve made.
Following this, they will signpost you to further help and indicate when repeat tests may be performed. Sometimes anti-dementia medication, or non-pharmaceutical treatments (e.g. Cognitive Stimulation Therapy), are recommended. If there is no diagnosis of dementia then you may be referred for memory rehabilitation to help improve your memory loss.
What happens at memory clinic follow-up appointments?
It’s very common for you to visit a memory clinic more than once. At subsequent appointments, the aim is to see how your memory and brain health is doing and monitor any rate of decline. Repeating tests can help to determine this. If treatment has been started then repeating the tests can help to determine their effectiveness.
At these appointments, medication is reviewed. Additionally, information about support and helpful strategies can be shared.
Preparing for your memory clinic appointment
It’s usual to feel a little apprehensive about any medical appointment. Remember that none of the tests are invasive and the purpose is to determine the right support for you.
It’s very important that you bring a family member or a close friend with you to your memory clinic appointments. Not only are they a support to you, they are also an important part of the process as they can share further information, with your consent.
It’s also helpful if you can take a list of any medications which you currently take. You’ll need your reading glasses if you wear them, and if you are a hearing aid user ensure these are in use.
You may also find it useful to write down any questions of concerns you have, or get the person accompanying you to write these down for you.
