SCREENING FOR DEMENTIA IN PRIMARY CARE. (11th November 2018)

• Record Type: Journal Article
• Authors: Koroukian, S; Smyth, K
• Is Part Of: Innovation in aging. Volume 2(2018)Supplement 1
• Page Start: 147
• Page End: 147
• Publication Date: 2018-11-11
• Subjects: Aging -- Periodicals; Gerontology -- Periodicals; 612.67
• DOI: 10.1093/geroni/igy023.534
• Languages: English
• ISSNs: 2399-5300

Abstract

Abstract: Government, research and advocacy groups have recommended using cognitive screening tools (CST) with older patients in ambulatory primary care settings, and identified criteria for tool selection. Studies have described the nature and psychometric properties of various CST. However, no systematic reviews of which CST are currently being recommended for use in literature targeted to practitioners in these settings has been done. We conducted such a review in family practice, geriatrics, internal medicine, psychiatry and nursing journals. PubMed, CINAHL and ProQuest searches yielded 850 unduplicated citations. Sixty-nine were retained after comparing titles and abstracts against inclusion/exclusion criteria, and 22 (in 18 different journals) after complete article review. Sixteen CST were recommended. The MMSE was recommended 11 times, the Mini-COG 5 and the Clock Drawing Test 4. Others received one recommendation each. Over 75% of these articles were addressed to physicians, and the rest to advanced practice nurses or physicians' assistants. Nearly 70% focused on assessment in a physician's office, outpatient clinic or neighborhood health center. The rest did not specify a setting. Less than half the articles discussed reliability, validity or effectiveness of the CST. When reported, tool administration time ranged from under 2 to 15 minutes. Feasibility of administration in the primary care setting was discussed in just over half the articles. We conclude that cognitive screening recommendations targeted directly to primary care clinicians vary considerably, and frequently omit consideration of tool quality or feasibility. More work is needed to transfer guideline-based CST selection criteria into primary care practice.