Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA.
Department of Humanities and Social Sciences, University of California, San Francisco, San Francisco, CA, USA.
J Alzheimers Dis. 2021;82(3):1001-1013. doi: 10.3233/JAD-201403.
Timely diagnosis of dementia is a global healthcare priority, particularly in low to middle income countries where rapid increases in older adult populations are expected.
To investigate global perspectives on the role of brief cognitive assessments (BCAs) in dementia diagnosis, strengths and limitations of existing measures, and future directions and needs.
This is a qualitative study of 18 dementia experts from different areas of the world. Participants were selected using purposeful sampling based on the following criteria: 1) practicing in countries with projected growth of older adult population of over 100%by 2050; 2) expertise in dementia diagnosis and treatment; 3) involvement in clinical practice and training; and 4) recognition as a national dementia expert based on leadership positions within healthcare system, research, and/or policy work. Participants were individually interviewed in their language of choice over secure videoconference sessions. Interviews were analyzed by a multidisciplinary team using theme identification approach.
Four domains with subthemes emerged illustrating participants' perspectives: 1) strengths of BCAs; 2) limitations of BCAs; 3) needs related to the use of BCAs; and 4) characteristics of an ideal BCA. While most experts agreed that BCAs were important and useful for dementia diagnosis, the themes emphasized the need for development and validation of novel measures that are sensitive, psychometrically sound, and culturally appropriate.
BCAs are important for guiding diagnosis and care for dementia patients. Findings provide a roadmap for novel BCA development to assist in diagnostic decision making for clinicians serving a rapidly growing and diverse dementia population.
及时诊断痴呆症是全球医疗保健的重点，特别是在中低收入国家，预计老年人口将迅速增加。
调查全球范围内对简短认知评估（BCA）在痴呆症诊断中的作用的看法、现有测量方法的优缺点，以及未来的方向和需求。
这是一项针对来自世界各地的 18 名痴呆症专家的定性研究。参与者是根据以下标准通过有目的的抽样选择的：1）在预计到 2050 年老年人口增长超过 100%的国家执业；2）在痴呆症诊断和治疗方面具有专业知识；3）参与临床实践和培训；4）在医疗保健系统、研究和/或政策工作中的领导地位被公认为国家痴呆症专家。参与者在他们选择的语言中通过安全的视频会议进行单独访谈。多学科团队使用主题识别方法对访谈进行分析。
有四个领域和子主题出现，说明了参与者的观点：1）BCA 的优势；2）BCA 的局限性；3）与使用 BCA 相关的需求；4）理想的 BCA 的特征。尽管大多数专家都认为 BCA 对痴呆症诊断很重要且有用，但这些主题强调了开发和验证新的、敏感的、心理测量上健全的和文化适当的测量方法的必要性。
BCA 对指导痴呆症患者的诊断和护理很重要。研究结果为新的 BCA 开发提供了路线图，以协助为服务于快速增长和多样化的痴呆症患者群体的临床医生做出诊断决策。
