Title : Mild cognitive impairment screening for older adults receiving home-based primary care: A clinical practice guideline
Abstract:
The purpose of this project was the development of a clinical practice guideline for early detection of mild cognitive impairment for adults over the age of 65 who receive home-based primary care (HBPC). There is currently no guideline for this population and setting. The AGREE II tool was chosen as a developmental framework due to its validity and reliability in CPG development. During development this author systematically screened articles from CINAHL, Cochrane Library, Embase, Google Scholar, PubMed, and Ovid. Exclusion criteria included no availability in English, focus on MCI in relation to a specific disease process, or having a population outside the target age range. This CPG is pending approval using the AGREE II tool by an expert panel. Recommendations include using alterations in the DSM-5 cognitive domains to guide assessment using a validated and reliable tool. The interviewer should select a tool based on sensitivity and specificity, availability in the patient's primary language, patient’s level of education, time to administer, and any visual, auditory, or motor impairment. Practice considerations include screening for comorbid mood disorders and home safety. Individuals with MCI are associated with lower quality of life and increased likelihood of progressing to dementia as compared with cognitively intact counterparts. Early detection may provide an opportunity for slowing disease progression and participation in advanced care planning.
