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Optimizing cognitive assessment in primary care to support a more effective route to dementia diagnosis

Why is this research needed?

Improved dementia diagnosis is a priority of the UK Government's National Dementia Challenge, as well as a key focus of the World Health Organisation and the G8. The Alzheimer’s Society’s recent report Dementia 2014: Opportunity for change (1) highlights the urgent need to create a diagnostic pathway which takes people fluently from first presentation to their GP through to memory clinics and long-term support mechanisms following a diagnosis.

As a result it is vital to address delays in the early stages of a person’s diagnostic journey in order to improve access to care and support for the individual and the people around them.

GPs are usually the first point of contact for patients and carers concerned about possible dementia, but it is not clear which tests for identifying dementia are easiest to use in primary care, and how accurate they are. Many GPs also report a lack of certainty in using assessment tools, as well as concerns about the consequences of misdiagnosing dementia.

Current evidence

The evidence base for using brief cognitive assessments is growing, and groups such as the Cochrane Dementia and Cognitive Improvement Group (2) have conducted individual systematic reviews to explore the accuracy of brief cognitive assessments for dementia in a range of different settings. However, there is a lack of evidence on how these tests compare to each other and how GPs use them in practice.

There is therefore a strong need to investigate how brief cognitive assessments for dementia are viewed in practice by the people who use them, and to identify the best assessments to use in primary care, in order to support a more effective route to dementia diagnosis.

This project aims to:

1. Determine current advice for GPs in using brief cognitive assessments for identifying dementia in primary care; 

2. Ascertain which brief cognitive assessments are available to GPs for dementia identification in primary care, particularly in the UK healthcare context ;

3. Explore which brief cognitive assessments are most accurate for GPs to use for dementia identification in primary care;

4. Investigate how brief cognitive assessments are viewed in practice by GPs.

For more information on this project, please read the current project proposal.

If you’d like to learn more, please contact Harriet Hunt via Email or follow her on Twitter @HarrietAHunt.

1 http://www.alzheimers.org.uk/site/scripts/download_info.php?fileID=2317
2 https://dementia.cochrane.org/

Publications

Hunt HA, Van Kampen S, Takwoingi Y, Llewellyn D J, Pearson M, Hyde CJ (2018). The comparative diagnostic accuracy of the Mini Mental State Examination (MMSE) and the General Practitioner assessment of Cognition (GPCOG) for identifying dementia in primary care: A systematic review protocol. Diagnostic and Prognostic Research 1(14) 

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