Tang Caiyun, Xiao Lily Dongxia, Huang Rong, Hu Ying, Wang Yao
Xiangya School of Nursing, Central South University, No. 172, Tongzipo Road, Yuelu District, Changsha, 410013, Hunan, China.
College of Nursing and Health Sciences, Flinders University, Sturt Road, Bedford Park, Adelaide, South Australia, 5042, Australia.
BMC Geriatr. 2025 Mar 15;25(1):178. doi: 10.1186/s12877-025-05824-w.
Previous studies have shown that the referral situation after cognitive screening is not optimistic. However, little is known about the situation in China. The current study assessed the cognitive function of older adults with an Eight-item Ascertain Dementia (AD8) score of ≥ 2 in a community health center and investigated their willingness to accept referrals.
In our cross-sectional study, a total of 970 participants completed a cognitive screen using AD8. Those with a score of ≥ 2 were further assessed using the Mini-Mental State Examination. Sociodemographic information was collected. The participants were asked to respond to a questionnaire about their acceptance and uptake of referral after screening and their knowledge of cognitive impairment. The data were analyzed using descriptive statistics, the chi-square test, the Mann-Whitney U rank sum test, and binary logistic regression.
We screened 140 older adults with cognitive impairment from 970 participants. Among the 140 subjects, 37 (26.43%) indicated a willingness to be referred, and 103 (73.57%) declined to be referred. We investigated the reasons for declining referrals, and 69 (66.99%) indicated that they thought referrals were unnecessary. The knowledge of referrals, attitude toward referrals, and knowledge of cognitive impairment showed significant differences concerning participants' willingness to be referred(all p < 0.01). The participants with high knowledge of cognitive impairment were willing to accept referrals (p = 0.009; OR = 1.305; 95% CI: 1.070-1.591).
Chinese older adults with cognitive impairment exhibit a low willingness to be referred. Health education in older adults is needed to raise awareness of cognitive impairment, dementia prevention, treatment, and care.
以往研究表明，认知筛查后的转诊情况不容乐观。然而，中国的情况鲜为人知。本研究评估了社区卫生中心中八条目痴呆筛查量表（AD8）评分≥2的老年人的认知功能，并调查了他们接受转诊的意愿。
在我们的横断面研究中，共有970名参与者使用AD8完成了认知筛查。得分≥2的参与者进一步使用简易精神状态检查表进行评估。收集了社会人口统计学信息。参与者被要求回答一份关于他们在筛查后接受和接受转诊的情况以及他们对认知障碍的了解的问卷。使用描述性统计、卡方检验、曼-惠特尼U秩和检验和二元逻辑回归分析数据。
我们从970名参与者中筛查出140名有认知障碍的老年人。在这140名受试者中，37名（26.43%）表示愿意被转诊，103名（73.57%）拒绝被转诊。我们调查了拒绝转诊的原因，69名（66.99%）表示他们认为转诊没有必要。关于转诊的知识、对转诊的态度以及对认知障碍的了解在参与者接受转诊的意愿方面存在显著差异（所有p<0.01）。对认知障碍了解程度高的参与者愿意接受转诊（p=0.009；OR=1.305；95%CI：1.070-1.591）。
中国有认知障碍的老年人接受转诊的意愿较低。需要对老年人进行健康教育，以提高对认知障碍、痴呆预防、治疗和护理的认识。
