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在初级保健中扩大使用简短认知评估来检测疑似早期认知障碍。

Expanding the use of brief cognitive assessments to detect suspected early-stage cognitive impairment in primary care.

机构信息

Brief Cognitive Assessment Work Group, District of Columbia, USA.

Center for Improving Chronic Illness Care, University of Southern California, Los Angeles, California, USA.

出版信息

Alzheimers Dement. 2023 Sep;19(9):4252-4259. doi: 10.1002/alz.13051. Epub 2023 Apr 19.

Abstract

INTRODUCTION

Mild cognitive impairment remains substantially underdiagnosed, especially in disadvantaged populations. Failure to diagnose deprives patients and families of the opportunity to treat reversible causes, make necessary life and lifestyle changes and receive disease-modifying treatments if caused by Alzheimer's disease. Primary care, as the entry point for most, plays a critical role in improving detection rates.

METHODS

We convened a Work Group of national experts to develop consensus recommendations for policymakers and third-party payers on ways to increase the use of brief cognitive assessments (BCAs) in primary care.

RESULTS

The group recommended three strategies to promote routine use of BCAs: providing primary care clinicians with suitable assessment tools; integrating BCAs into routine workflows; and crafting payment policies to encourage adoption of BCAs.

DISSCUSSION

Sweeping changes and actions of multiple stakeholders are necessary to improve detection rates of mild cognitive impairment so that patients and families may benefit from timely interventions.

摘要

简介

轻度认知障碍的诊断率仍然明显较低,尤其是在弱势群体中。未能诊断会使患者和家属错失治疗可逆病因、进行必要的生活和生活方式改变以及接受阿尔茨海默病治疗的机会。作为大多数人的切入点,初级保健在提高检出率方面发挥着关键作用。

方法

我们召集了一个由国家专家组成的工作组,为政策制定者和第三方支付者制定了关于在初级保健中增加使用简短认知评估(BCA)的方法的共识建议。

结果

该小组建议了三种促进常规使用 BCA 的策略:为初级保健临床医生提供合适的评估工具;将 BCA 整合到常规工作流程中;制定支付政策以鼓励采用 BCA。

讨论

需要多方利益相关者进行全面改革和采取行动,以提高轻度认知障碍的检出率,使患者和家属能够受益于及时的干预措施。

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