American Academy of Family Physicians

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Dementia - Screening and Diagnosis of Early Cognitive Impairment

Study Description and Methods

In this random-controlled trial we tested two screening tools, Blessed Orientation-Memory-Concentration test (BOMC) & Clock Drawing Test (CDT), to determine realistic ways to diagnose Early Cognitive Impairment (ECI). We wanted to demonstrate the practicality of integrating a two-stage testing process to identify patients with ECI into the daily practices of family physicians and other primary care providers.

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Specific Aims and Objectives

Four objectives were addressed in this study:
  1. To determine whether family physicians and their office staff prefer using the Blessed Orientation-Memory-Concentration test (BOMC) or the Clock Drawing Test (CDT) as an instrument to screen their older patients for early cognitive impairment (ECI);
  2. To evaluate family physicians’ willingness to implement routine screening of their older patients for ECI in their daily practice;
  3. To determine whether family physicians are willing to follow-up with patients who test positive on the initial screen (based on results from either BOMC or CDT) by having them return for diagnostic testing; and
  4. To assess patients’ responses to general screening and willingness of patients who have a positive screen for ECI to return for a subsequent appointment for diagnostic testing using the MCIS test.

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Timeline

This study was conduced between October 1, 2007 through September 30, 2008.

Status

This project is currently closed, a manuscript is being written.

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Contact Information

For additional information about this study, please contact:

James M. Galliher, PhD
Principal Investigator
AAFP National Research Network
1-800-274-2237, x3170
jgallihe@aafp.org

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Key Findings

Based on the study results, we can say that if screening and diagnostic testing for ECI/dementia as demonstrated in this project is going to be implemented in primary care offices, there must be:
  • ways to implement this process without disrupting ordinary practice flow, including alternatives for its implementation that can be shown to work;
  • reimbursable to the extent to which it will be worth the effort financially for the practice to implement systematically; and
  • (Probably most importantly) effective treatments for ECI and dementia or demonstration of other benefits from early recognition of the problem.

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This was funded by a grant from Extendicare Foundation (Milwaukee, WI).

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