Cognitive Screening Made Easy for Primary Care Providers

项目摘要 在美国和世界各地，人们都在长寿。随着人口老龄化，人口也在老龄化 可能在记忆力、注意力、推理或其他思维能力方面有所下降的老年人人数。 如果及早发现，这些认知变化中的一些是可以治疗和逆转的。其他人可以放慢脚步 希望有一天能阻止。不幸的是，认知功能减退或非常轻微的痴呆症患者通常 直到病程后期治疗效果较差时才被认识到。作为第一个医疗保健 专业大多数人就医疗问题伸出援手，初级保健提供者在以下方面发挥关键作用 及早发现认知功能减退。虽然许多初级保健提供者在Medicare进行认知筛查 每年一次的健康访问，当患者表达担忧时，90%的人希望获得更多关于谁的信息 筛查，使用哪种评估工具，如果筛查是阳性的，应该说些什么。决定和谁一起筛选 一个简短的认知评估工具是这一过程的关键部分，因为不是每个人都需要进行筛查，而且 初级保健提供者已经面临时间压力，需要解决他们的明显和紧迫的关切 病人。该项目的长期目标是开发一种风险评估和认知筛选工具， 只需要初级保健提供者或其工作人员最少的时间和精力，并对认知能力下降敏感 来自不同教育和种族/民族背景的老年人。该工具将集成到电子产品中 健康记录系统，使初级保健提供者和患者更容易看到结果。具体目标 该项目的第一阶段是修改现有的痴呆症风险筛查指数，以识别老年人 谁是认知障碍的高危人群，开发一个简短的认知评估工具，使用以下任务 老年人容易表现，但对认知能力下降敏感，证实它们在150名患有 已经很好地定义的不同水平的认知能力，以及测试将发现整合到 电子健康记录。第二阶段的具体目标是进一步测试 新开发的工具，在250名在初级保健诊所接受护理的老年人中，找出初级保健 供应商使用该工具的程度，他们喜欢它，它是否有用和易于使用，并整合发现 进入多个电子健康记录系统。此项目的发现将填补现有工具包中的空白 初级保健提供者，并将使认知能力下降的筛查快速、容易和有效。

Project Summary In the United States and around the world, people are living longer lives. As the population ages, so does the number of older adults who may experience declines in memory, attention, reasoning, or other thinking skills. Some of these changes in cognition can be treated and reversed if caught early. Others can be slowed down and hopefully one day prevented. Unfortunately, people with cognitive decline or very mild dementia often are not recognized until late in the disease course when treatments are less effective. As the first health care professional most people reach out to about medical concerns, primary care providers play a critical role in detecting cognitive decline early. While many primary care providers conduct cognitive screening at Medicare Annual Wellness Visits and when patients voice concerns, 9 out of 10 would like more information about who to screen, which assessment tool to use, and what to say if screening is positive. Deciding who to screen with a brief cognitive assessment tool is a key part of the process because not everyone needs to be screened, and primary care providers already face time pressures to address the obvious and immediate concerns of their patients. The long-term goal of this project is to develop a risk assessment and cognitive screening tool that requires minimal time and effort from primary care providers or their staff and is sensitive to cognitive decline in older adults from diverse educational and racial/ethnic backgrounds. The tool will be integrated into electronic health record systems to make it easy for primary care providers and patients to see results. The specific aims of the first phase of the project are to modify an existing dementia risk screening index to identify older adults who are at high-risk for cognitive impairment, develop a brief cognitive assessment tool using tasks that are easy for older adults to perform yet are sensitive to cognitive decline, confirm their utility in 150 people with varying levels of cognitive abilities that have already been well defined, and test ways to integrate findings into the electronic health record. The specific aims for the second phase are to further test the effectiveness of the newly developed tool in 250 older adults receiving care in a primary care clinic, to find out from primary care providers using the tool how much they liked it and if it was useful and easy to use, and to integrate findings into multiple electronic health record systems. Findings from this project will fill a gap in the existing toolkit of primary care providers and will make screening for cognitive decline quick, easy, and effective.