Expanding the use of brief cognitive assessments to detect suspected early‐stage cognitive impairment in primary care

Author:

Mattke Soeren12,Batie Donnie13,Chodosh Joshua145,Felten Kristen16,Flaherty Ellen178,Fowler Nicole R.191011,Kobylarz Fred A.112,O'Brien Kelly13,Paulsen Russ13,Pohnert Anne114,Possin Katherine L.115,Sadak Tatiana116,Ty Diane117,Walsh Amy118,Zissimopoulos Julie M.119

Affiliation:

1. Brief Cognitive Assessment Work Group District of Columbia USA

2. Center for Improving Chronic Illness Care University of Southern California Los Angeles California USA

3. Baton Rouge General Medical Center Baton Rouge Louisiana USA

4. Division of Geriatric Medicine and Palliative Care Department of Medicine New York University School of Medicine New York New York USA

5. NYU School of Medicine New York Harbor VA Healthcare System New York New York USA

6. Wisconsin Department of Health Services Office on Aging Madison Wisconsin USA

7. Geisel School of Medicine Dartmouth College Lebanon New Hampshire USA

8. Dartmouth Centers for Health and Aging Geisel School of Medicine Lebanon New Hampshire USA

9. Indiana University Center for Aging Research Indiana University School of Medicine and the Regenstrief Institute Indianapolis Indiana USA

10. Division of General Internal Medicine and Geriatrics Indiana University School of Medicine Indianapolis Indiana USA

11. Center for Health Innovation and Implementation Science Indiana University Indianapolis Indiana USA

12. Department of Family Medicine and Community Health Robert Wood Johnson Medical School Rutgers Biomedical and Health Sciences New Brunswick New Jersey USA

13. UsAgainstAlzheimer's Washington, District of Columbia USA

14. CVS Health MinuteClinic Woonsocket Rhode Island USA

15. Department of Neurology University of California, San Francisco Memory and Aging Center San Francisco California USA

16. University of Washington School of Nursing Seattle Washington USA

17. Alliance to Improve Dementia Care Milken Institute Center for the Future of Aging Washington, District of Columbia USA

18. Age‐Friendly Health Systems Institute for Healthcare Improvement Boston Massachusetts USA

19. Sol Price School of Public Policy University of Southern California Los Angeles California USA

Abstract

AbstractIntroductionMild cognitive impairment remains substantially underdiagnosed, especially in disadvantaged populations. Failure to diagnose deprives patients and families of the opportunity to treat reversible causes, make necessary life and lifestyle changes and receive disease‐modifying treatments if caused by Alzheimer's disease. Primary care, as the entry point for most, plays a critical role in improving detection rates.MethodsWe convened a Work Group of national experts to develop consensus recommendations for policymakers and third‐party payers on ways to increase the use of brief cognitive assessments (BCAs) in primary care.ResultsThe group recommended three strategies to promote routine use of BCAs: providing primary care clinicians with suitable assessment tools; integrating BCAs into routine workflows; and crafting payment policies to encourage adoption of BCAs.DisscussionSweeping changes and actions of multiple stakeholders are necessary to improve detection rates of mild cognitive impairment so that patients and families may benefit from timely interventions.

Publisher

Wiley

Subject

Psychiatry and Mental health,Cellular and Molecular Neuroscience,Geriatrics and Gerontology,Neurology (clinical),Developmental Neuroscience,Health Policy,Epidemiology

Reference37 articles.

1. American Academy of Neurology.AAN summary of practice guideline for clinicians: mild cognitive impairment.2017.https://www.aan.com/Guidelines/home/GetGuidelineContent/882

2. Practice guideline update summary: Mild cognitive impairment

3. Alzheimer's Association.2021 Alzheimer's disease facts and figures: special report: race ethnicity and Alzheimer's in America.2021. Last accessed December 2022:https://www.alz.org/media/Documents/alzheimers‐facts‐and‐figures.pdf

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