Case Finding of Mild Cognitive Impairment and Dementia and Subsequent Care; Results of a Cluster RCT in Primary Care

Dungen, Pim van den; Charante, Eric P. Moll van; Ven, Peter M. van de; Marwijk, Harm van; Horst, Henriëtte E. van der; Hout, Hein van

doi:10.1371/journal.pone.0156958

Cited by 12 publications

(24 citation statements)

References 65 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 78.3% of GPs considered AD8 useful Thyrian 50 2016, Germany 516 80 59.5% Female Dementia MCI GP’s evaluation; ICD-10 MCI-90.8% Dementia-99.8% Older adults from primary health care are considerably underdiagnosed Koekkoek 51 2015, Netherlands 513 >70 MCI GP’s evaluation; DSM-IV (Dementia); Winblad et al (MCI) 15.2% This study protocol describes all the procedures for the Cog-ld study Chan 52 2016, Singapore 309 71.7 (±8.2) 60.5% Female Dementia DSM-IV; CDR 36.5% For participant age, AD8 was better than MMSE and as good as MoCA Koekkoek 53 2016, Netherlands 228 76.8 60% Male MCI DSM-IV (Dementia); Winblad et al (MCI) 19.3% TYM’s negative predictive value (NPV) was 81% and SAGE’s was 85%. GP’s evaluations had a similar NPV, however, the positive predictive value was higher Dungen 54 2015, Netherlands 647 79.8 (±7.1) 39.6% Male Dementia MCI DSM-IV (Dementia); Petersen at al. (MCI) Dementia -14% MCI-31.5% The authors did not find statistical relevance in the number of diagnoses between the groups before or after intervention Groeneveld …”

Section: Main Characteristics Of the Studies Selected For Analysis Smentioning

confidence: 95%

Diagnosing dementia and cognitive dysfunction in the elderly in primary health care: A systematic review

Pelegrini

Mota

Ramos

et al. 2019

Dement. neuropsychol.

View full text Add to dashboard Cite

ABSTRACT. Dementia is a public health issue making the screening and diagnosing of dementia and its prodromal phases in all health settings imperative. Objective: using PRISMA, this systematic review aimed to identify how low-, middle-, and high-income countries establish dementia and cognitive dysfunction diagnoses in primary health care. Methods: studies from the past five years in English, Spanish, and Portuguese were retrieved from Scopus, PubMed, Embase, Lilacs, Scielo, and Web of Science. Of 1987 articles, 33 were selected for analysis. Results: only three articles were from middle-income countries and there were no studies from low-income countries. The most used instrument was the Mini-Mental State Examination (MMSE). Mild Cognitive Impairment (MCI) and dementia criteria were based on experts’ recommendation as well as on the Diagnostic and Statistical Manual of Mental Disorders (DSM) and International Classification of Diseases (ICD-10), respectively. Conclusion: differences between these criteria among high- and middle-income countries were observed.

show abstract

Section: Main Characteristics Of the Studies Selected For Analysis Smentioning

confidence: 95%

Diagnosing dementia and cognitive dysfunction in the elderly in primary health care: A systematic review

Pelegrini

Mota

Ramos

et al. 2019

Dement. neuropsychol.

View full text Add to dashboard Cite

show abstract

“…Four studies [15,18,19,35] evaluated dementia care management in primary health care. Exploring dementia care knowledge and attitudes of primary health care practitioners was the focus of three studies [3,11,12].…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Randomised Controlled Trials Three studies utilised an RCT [15,18,19] to investigate the impact of collaborative care on quality of life for people with dementia and their caregivers. The study by Van den Dungen et al, [15] also included an evaluation of family practitioner training on diagnosis of mild cognitive impairment.…”

Section: Quantitative Studiesmentioning

confidence: 99%

See 1 more Smart Citation

What is the role of the practice nurse in the care of people living with dementia, or cognitive impairment, and their support person(s)?: a systematic review

2020

View full text Add to dashboard Cite

Background: The potential value of expanding the Practice Nurse role to include the recognition and management of dementia has been acknowledged. Practice Nurses are well-positioned to provide comprehensive dementia information and support so that people living with dementia are better equipped to self-manage their health and live well with dementia. The purpose of this review was to systematically examine published literature to identify existing and potential roles of Practice Nurse's in the delivery of care to people affected by dementia and to describe the characteristics and effectiveness of nurse interventions in dementia models of care. Methods: The PRISMA statement guided the systematic review of the quantitative and qualitative evidence for roles and characteristics of the Practice Nurse in the delivery of dementia care. A comprehensive literature search of seven electronic databases and Google scholar identified relevant original research published in English between January 2000 and January 2019. Thirteen articles met the inclusion criteria and were extracted into the Covidence software for analysis. Results: The heterogeneity of the included studies purpose, design and outcomes measures and the diversity in health systems and primary care nurses scope of practice made it difficult to synthesise the findings and draw conclusions. The heterogeneity did, however, provide important insights into the characteristics of roles undertaken by nurses working in the general practice setting, which were potentially beneficial to people living with dementia and their support person. These included patient accessibility to the Practice Nurse, early recognition and management of cognitive changes, care management and collaboration with the General Practitioner. Limitations of the provision of dementia care by Practice Nurses included a lack of definition of the role, inadequate dementia specific training, time constraints and poor communication with General Practitioners. Conclusions: Embedding an evidence-based model that describes the role of the Practice Nurse in dementia care provision has the potential to increase early recognition of cognitive impairment and more appropriate primary care management of dementia. Systematic review registration: PROSPERO 2018 CRD42018088191.

show abstract

“… 47 48 This study also shows that healthcare professionals view case-finding as a politically and financially driven initiative with little or no evaluation of the outcomes. 30 33 44 From the limited research to date on the impact of policies aiming to increase dementia diagnosis rates in general practice, there is insufficient evidence of effect 49 and even a suggestion that when referrals from general practice for dementia assessment increased, the proportion among these who were subsequently diagnosed with dementia fell. 50 …”

Section: Discussionmentioning

confidence: 99%

Dementia case-finding in hospitals: a qualitative study exploring the views of healthcare professionals in English primary care and secondary care

et al. 2018

View full text Add to dashboard Cite

ObjectivesIn 2012–2013, the English National Health Service mandated hospitals to conduct systematic case-finding of people with dementia among older people with unplanned admissions. The method was not defined. The aim of this study was to understand current approaches to dementia case-finding in acute hospitals in England and explore the views of healthcare professionals on perceived benefits and challenges.DesignQualitative study involving interviews, focus groups and thematic content analysis.SettingPrimary care and secondary care across six counties in the East of England.ParticipantsHospital staff involved in dementia case-finding and primary care staff in the catchment areas of those hospitals.ResultsWe recruited 23 hospital staff and 36 primary care staff, including 30 general practitioners (GPs). Analysis resulted in three themes: (1) lack of consistent approaches in case-finding processes, (2) barriers between primary care and secondary care which impact on case-finding outcomes and (3) perceptions of rationale, aims and impacts of case-finding. The study shows that there were variations in how well hospitals recorded and reported outcomes to GPs. Barriers between primary care and secondary care, including GPs’ lack of access to hospital investigations and lack of clarity about roles and responsibilities, impacted case-finding outcomes. Staff in secondary care were more positive about the initiative than primary care staff, and there were conflicting priorities for primary care and secondary care regarding case-finding.ConclusionsThe study suggests a more evidence-based approach was needed to justify approaches to dementia case-finding. Information communicated to primary care from hospitals needs to be comprehensive, appropriate and consistent before GPs can effectively plan further investigation, treatment or care. Follow-up in primary care further requires access to options for postdiagnostic support. There is a need to evaluate the outcomes for patients and the economic impact on health and care services across settings.

show abstract

Case Finding of Mild Cognitive Impairment and Dementia and Subsequent Care; Results of a Cluster RCT in Primary Care

Cited by 12 publications

References 65 publications

Diagnosing dementia and cognitive dysfunction in the elderly in primary health care: A systematic review

Diagnosing dementia and cognitive dysfunction in the elderly in primary health care: A systematic review

What is the role of the practice nurse in the care of people living with dementia, or cognitive impairment, and their support person(s)?: a systematic review

Dementia case-finding in hospitals: a qualitative study exploring the views of healthcare professionals in English primary care and secondary care

Contact Info

Product

Resources

About