scholarly journals EARLY DETECTION OF MILD COGNITIVE IMPAIRMENT (MCI) IN PRIMARY CARE

2020 ◽  
pp. 1-6
Author(s):  
M.N. Sabbagh ◽  
M. Boada ◽  
S. Borson ◽  
M. Chilukuri ◽  
B. Dubois ◽  
...  
Keyword(s):  
Primary Care ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Performance ◽  
Large Scale ◽  
Care Setting ◽  
Primary Care Setting ◽  
Cognitive Screening ◽  
Patient Journey ◽  
Cognitive Evaluation

Mild cognitive impairment (MCI) is significantly misdiagnosed in the primary care setting due to multi-dimensional frictions and barriers associated with evaluating individuals’ cognitive performance. To move toward large-scale cognitive screening, a global panel of clinicians and cognitive neuroscientists convened to elaborate on current challenges that hamper widespread cognitive performance assessment. This report summarizes a conceptual framework and provides guidance to clinical researchers and test developers and suppliers to inform ongoing refinement of cognitive evaluation. This perspective builds upon a previous article in this series, which outlined the rationale for and potentially against efforts to promote widespread detection of MCI. This working group acknowledges that cognitive screening by default is not recommended and proposes large-scale evaluation of individuals with a concern or interest in their cognitive performance. Such a strategy can increase the likelihood to timely and effective identification and management of MCI. The rising global incidence of AD demands innovation that will help alleviate the burden to healthcare systems when coupled with the potentially near-term approval of disease-modifying therapies. Additionally, we argue that adequate infrastructure, equipment, and resources urgently should be integrated in the primary care setting to optimize the patient journey and accommodate widespread cognitive evaluation.

scholarly journals Prevalence of dementia and cognitive impairment with no dementia in a primary care setting in southern Brazil

2021 ◽  
Vol 79 (7) ◽  
pp. 565-570
Author(s):  
Sérgio Ferreira de Ferreira-Filho ◽  
Wyllians Vendramini Borelli ◽  
Rodrigo Mantovani Sguario ◽  
Gustavo Fiorentin Biscaia ◽  
Vitória Schneider Müller ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Medical Records ◽  
Care Setting ◽  
Primary Care Setting ◽  
Cognitive Screening ◽  
Southern Brazil ◽  
Symptoms Of Depression

ABSTRACT Background: Cognitive decline is a common condition, but is still underrepresented in studies conducted in developing countries. Objective: To calculate the prevalence of cognitive decline and depression in an elderly community-dwelling population in a city in southern Brazil. Methods: We calculated the prevalences of dementia, cognitive impairment with no dementia (CIND) and symptoms of depression in an elderly population relying on the public healthcare system. This epidemiological study in Pelotas, Brazil, was conducted within the primary care setting. It included 299 older adults (mean age = 69.75 ± 7.6 years) who presented low levels of education (mean = 4.16 ± 3.17 years of education). They underwent cognitive screening and their medical records were analyzed. Results: Among these older adults, 142 (47.5%) presented cognitive decline: 104 (34.8%) matching the cognitive criteria for CIND and 38 (12.7%) matching the cognitive criteria for dementia. Among all the individuals who completed the cognitive screening, 141 (48.4%) were positive for symptoms of depression, of whom 99 (34%) did not have any previous diagnosis in their medical records. Conclusion: There was high prevalence of cognitive impairment among these older adults in a primary care setting. A large number of older adults were found to have symptoms of depression without any diagnosis.

THE ROAD AHEAD TO CURE AND PREVENT ALZHEIMER’S DISEASE: IMPLEMENTING PREVENTION INTO PRIMARY CARE

2015 ◽  
pp. 1-11
Author(s):  
B. Fougère ◽  
B. Vellas ◽  
J. Delrieu ◽  
A.J. Sinclair ◽  
A. Wimo ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Cognitive Impairment ◽  
Primary Care Physicians ◽  
Large Scale ◽  
Objective Assessment ◽  
Epidemiological Studies ◽  
Cognitive Status ◽  
Cognitive Screening ◽  
Cognitive Complaint

Most old adults receive their health care from their primary care practitioner; as a consequence, as the population ages, the manifestations and complications of cognitive impairment and dementia impose a growing burden on providers of primary care. Current guidelines do not recommend routine cognitive screening for older persons by primary care physicians, although the vast majority recommend a cognitive status assessment and neurological examination for subjects with a cognitive complaint. Also, no clinical practice guidelines recommend interventions in older adults with cognitive impairment in primary care settings. However, primary care physicians need to conduct a review of risks and protective factors associated with cognitive decline and organize interventions to improve or maintain cognitive function. Recent epidemiological studies have indicated numerous associations between lifestyle-related risk factors and incidental cognitive impairment. The development of biomarkers could also help in diagnosis, prognosis, selection for clinical trials, and objective assessment of therapeutic responses. Interventions aimed at cognitive impairment prevention should be pragmatic and easy to implement on a large scale in different health care systems, without generating high additional costs or burden on participants, medical and social care teams.

scholarly journals RATIONALE FOR EARLY DIAGNOSIS OF MILD COGNITIVE IMPAIRMENT (MCI) SUPPORTED BY EMERGING DIGITAL TECHNOLOGIES

2020 ◽  
pp. 1-7
Author(s):  
M.N. Sabbagh ◽  
M. Boada ◽  
S. Borson ◽  
M. Chilukuri ◽  
P.M. Doraiswamy ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Early Diagnosis ◽  
Cognitive Performance ◽  
Working Group ◽  
Large Scale ◽  
Care Delivery ◽  
Consumer Electronics ◽  
Advisory Group ◽  
Diagnosis And Management

Disease-modifying pharmacotherapies for Alzheimer’s Disease (AD) are currently in late-stage clinical development; once approved, new healthcare infrastructures and services, including primary healthcare, will be necessary to accommodate a huge demand for early and large-scale detection of AD. The increasing global accessibility of digital consumer electronics has opened up new prospects for early diagnosis and management of mild cognitive impairment (MCI) with particular regard to AD. This new wave of innovation has spurred research in both academia and industry, aimed at developing and validating a new “digital generation” of tools for the assessment of the cognitive performance. In light of this paradigm shift, an international working group (the Global Advisory Group on Future MCI Care Pathways) convened to elaborate on how digital tools may be optimally integrated in screening-diagnostic pathways of AD The working group developed consensus perspectives on new algorithms for large-scale screening, detection, and diagnosis of individuals with MCI within primary medical care delivery. In addition, the expert panel addressed operational aspects concerning the implementation of unsupervised at-home testing of cognitive performance. The ultimate intent of the working group’s consensus perspectives is to provide guidance to developers of cognitive tests and tools to facilitate the transition toward globally accessible cognitive screening aimed at the early detection, diagnosis, and management of MCI due to AD.

scholarly journals Alzheimer's Association recommendations for operationalizing the detection of cognitive impairment during the Medicare Annual Wellness Visit in a primary care setting

2012 ◽  
Vol 9 (2) ◽  
pp. 141-150 ◽  
Author(s):  
Cyndy B. Cordell ◽  
Soo Borson ◽  
Malaz Boustani ◽  
Joshua Chodosh ◽  
David Reuben ◽  
...  
Keyword(s):  
Primary Care ◽  
Cognitive Impairment ◽  
Care Setting ◽  
Primary Care Setting

scholarly journals Integrated Cognitive Assessment: Speed and Accuracy of Visual Processing as a Reliable Proxy to Cognitive Performance

2018 ◽  
Author(s):  
Seyed-Mahdi Khaligh-Razavi ◽  
Sina Habibi ◽  
Maryam Sadeghi ◽  
Haniye Marefat ◽  
Mahdiyeh Khanbagi ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mental Disorders ◽  
Cognitive Performance ◽  
Visual Processing ◽  
Cognitive Assessment ◽  
Large Scale ◽  
Assessment Tool ◽  
Cognitive Screening ◽  
Current Standard ◽  
Language And Education

AbstractVarious mental disorders are accompanied by some degree of cognitive impairment. Particularly in neurodegenerative disorders, cognitive impairment is the phenotypical hallmark of the disease. Effective, accurate and timely cognitive assessment is key to early diagnosis of this family of mental disorders. Current standard-of-care techniques for cognitive assessment are primarily paper-based, and need to be administered by a healthcare professional; they are additionally language and education-dependent and typically suffer from a learning bias. These tests are thus not ideal for large-scale pro-active cognitive screening and disease progression monitoring. We developed the Integrated Cognitive Assessment (ICA), a 5-minute computerized cognitive assessment tool based on a rapid visual categorization task, in which a series of carefully selected natural images of varied difficulty are presented to participants. Overall 448 participants, across a wide age-range with different levels of education took the ICA test. We compared participants’ ICA test results with a variety of standard pen-and-paper tests that are routinely used to assess cognitive performance. ICA had excellent test-retest reliability, and was significantly correlated with all the reference cognitive tests used here, demonstrating ICA’s ability as one unified test that can assess various cognitive domains.

scholarly journals Evaluation of a brief cognitive screening tool in primary care setting

2015 ◽  
Vol 357 ◽  
pp. e129
Author(s):  
D. Jiménez ◽  
M. Lavados ◽  
P. Rojas ◽  
C. Henriquez ◽  
M. Guillon ◽  
...  
Keyword(s):  
Primary Care ◽  
Care Setting ◽  
Screening Tool ◽  
Primary Care Setting ◽  
Cognitive Screening
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