Center for cognitive impairaments

Assist. prof. Milica Gregorič Kramberger, MD, PhD
Head

 

The Centre for cognitive impairments is the single point of referral for all people with a possible diagnosis of dementia from general practitioners and other specialized medical services in Slovenia.
Major activity of the centre is a professional treatment of patients with dementia, especially of those who have atypical, reversible, rapidly progressive, or early onset dementias as well as of patients in whom dementia is a concomitant disease.
The objective of the centre is to offer a responsive service to aid early identification of the dementia, including a full range of assessment, diagnostic, therapeutic, and rehabilitation services to accommodate the needs of people with different types and severities of dementia and the needs of their carers in partnership with local health, social care, and voluntary organisations.
Another important role of the centre is the research activity, in cooperation with the staff and capacities of the Movement disorder and gait lab and Cognitive neurophysiology lab.


Outpatient dementia management is oriented towards diagnostic and therapeutic service of patients in the early stages of dementia, with a special emphasis on patients who need urgent hospitalization: young patients, patients with fast developing dementias, potentially reversible dementias and atypical dementias.
Most of the patients which are being sent to the centre, can be managed as out-patients (out-patient activity within the centre is organized twice or three times a week, three to four hours a day). This includes detailed cognitive and general neurological examination, consultation with a specialized nurse as well as laboratory and/or imaging and neurophysiological investigations, psychological consultation, and consulting with social worker, occupational therapist or physiotherapist.
After the initial investigations, the patients, depending on the results, can be sent to additional in-patient management.
After diagnosing dementia, the stuff from the centre for cognitive impairments, offer follow-up to monitor cognitive decline and other signs of dementia in order to plan care and educate and inform carers about the course, treatment options, prognosis of the disease and inform them about the existing of help services, and charity associations – Spominčica and other legal aspects of the disease itself.
At regular interval (usually every 4-6 months), subsequently assessment (MMT, FAQ, NPI (behavioural and mood)) should be made for medical comorbidities and key psychiatric features associated with dementia, including depression and psychosis, to ensure optimal management of coexisting conditions. Records from the heteroanamnestic informations and the basic parameters from the “control panel for complete geriatric evaluation” are also done.

Inpatient dementia management is a type of management suggested to minority of patients who have dementia (younger patients, complicated and atypical disease forms, patients with reversible types of dementia, rapidly progressive dementias), who need urgent hospitalization with well-structured diagnostic procedure, which includes neuropsychological examination, electrophysiological and imaging (structural as well as functional) and biochemical tests, and adequate pharmacological and non-pharmacological therapy. Soon we will be able to use cerebrospinal fluid diagnostics of dementia.

Professionals that participate in the activities of the team

  • Neurologists
  • Psychiatrist
  • Clinical psychologists
  • Specialized dementia nurse
  • Social worker
  • Occupational therapist
  • Physiotherapist
  • Speech therapist
  • Nurses

In the team, occasionally, a neuroradiologist is taking an active part, as well as nuclear medicine specialist, pharmacologist and dietetic.

We also plan to organize educational courses for the professionals that work in the centre (specialized nurses, clinical psychologists, and neurologists) in Slovenia and other dementia centres worldwide.

Author: Assis. prof. Milica Gregorič-Kramberger, MD, PhD