痴呆症与老年人口：矫正卫生中的认知筛查。
Dementia and the aging population: cognitive screening within correctional health.
机构信息
Department of Research and Consulting, National Association of State Mental Health Program Directors Research Institute, Falls Church, Virginia, USA.
出版信息
Int J Prison Health. 2023 Mar 16;19(1):63-76. doi: 10.1108/IJPH-08-2021-0070. Epub 2022 Jun 29.
PURPOSE
The purpose of this study was to examine the literature surrounding dementia in the aging correctional population and assess the role of cognitive screening related to dementia detection within corrections. The literature regarding the role of dementia within the justice continuum is scant. Furthermore, correctional health researchers have not reached a consensus on the best age to administer cognitive screening in older persons or prioritizes a screening tool for the early detection of dementia.
DESIGN/METHODOLOGY/APPROACH: A key search term list including dementia screening and was developed to review the literature surrounding dementia and the aging correctional population. PubMed, Criminal Justice Abstracts (Ebsco) and the National Criminal Justice Reference Service were used within the academic search. A gray literature search using these same search terms was conducted reviewing criminal justice federal agencies and organizations for additional information on the dementia experience within correctional settings. Snowballing was used to capture relevant theoretical and empirical knowledge.
FINDINGS
Shortages in aging specialized health-care staffing presents a barrier for the clinical interpretation of Montreal Cognitive Assessment (MoCA) results. Correctional officers are also identified as useful candidates within the administration of cognitive screening with proper training. The MoCA may be the optimal cognitive screening tool for dementia, until an original cognitive screening tool is created specific to the correctional population. An age of 55 years or older may serve as the best cutoff score for classifying incarcerated individuals as older persons, and screening should be prioritized for these individuals. Finally, new specialized programs related to dementia within correctional settings are identified.
RESEARCH LIMITATIONS/IMPLICATIONS: A limitation of this research is the conflicting opinions among researchers regarding the use of general cognitive screening tools within the correctional setting.
ORIGINALITY/VALUE: This research can inform correctional organizational policy and practices regarding the screening of older persons suspected of dementia. Most notably, this research proposes that correctional settings should incorporate the MoCA within initial screening of all individuals 55 years of age or older, enriching the job design of correctional officer's job positions to include cognitive testing, and for correctional settings to provide dementia and age-associated training for correctional officers. Finally, this paper informs future research in the development of a cognitive assessment tool specific to the correctional population.
目的
本研究旨在探讨老龄化矫正人群中痴呆症的相关文献，并评估认知筛查在矫正领域中检测痴呆症的作用。关于司法系统中痴呆症作用的文献很少。此外，矫正健康研究人员尚未就老年人进行认知筛查的最佳年龄达成共识，也没有为早期发现痴呆症而确定首选的筛查工具。
设计/方法/方法：制定了一个关键的搜索词列表，包括痴呆症筛查，并用于审查有关痴呆症和老龄化矫正人群的文献。在学术搜索中使用了 PubMed、Criminal Justice Abstracts（Ebsco）和 National Criminal Justice Reference Service。使用相同的搜索词进行了灰色文献搜索，审查了刑事司法联邦机构和组织，以获取有关矫正环境中痴呆症经历的更多信息。滚雪球法用于获取相关的理论和经验知识。
发现
老龄化专业医疗保健人员短缺，对蒙特利尔认知评估（MoCA）结果的临床解释构成了障碍。经过适当的培训，矫正官员也被确定为认知筛查管理中的有用候选人。MoCA 可能是痴呆症的最佳认知筛查工具，直到创建专门针对矫正人群的原始认知筛查工具为止。55 岁或以上的年龄可能是将被监禁者归类为老年人的最佳截止分数，并且应优先为这些人进行筛查。最后，确定了与矫正环境中痴呆症相关的新的专门计划。
研究局限性/影响：这项研究的局限性在于研究人员对在矫正环境中使用通用认知筛查工具存在不同意见。
原创性/价值：这项研究可以为矫正组织的政策和实践提供信息，以筛查疑似痴呆症的老年人。最重要的是，这项研究建议矫正机构应将 MoCA 纳入所有 55 岁或以上人群的初始筛查中，丰富矫正官员工作职位的工作设计，包括认知测试，并为矫正机构提供针对矫正官员的痴呆症和与年龄相关的培训。最后，本文为开发专门针对矫正人群的认知评估工具提供了未来的研究方向。
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