Research on cognitive impairment in community and home settings

Mounting evidence demonstrates the significant impact of cognitive impairment on the lives of older adult patients and their caregivers. In addition, cognitive impairment presents challenging conditions for healthcare providers who are frequently unprepared to manage the care of these patients. These developments have spawned a wide range of research to more effectively identify and diagnose individuals with cognitive impairments, to develop better strategies to differentiate the types of cognitive impairment, and more accurately estimate the incidence and prevalence of the different types of impairments within different treatment settings. The 4 articles presented in this article represent a small sampling of recent research on these topics. Each article possesses methodological and other limitations that limit the generalizability of their findings. Nonetheless, there are important lessons to be learned from each. The first article examines the effectiveness of using a single-item measure to screen for delirium, one form of cognitive impairment. The second article presents the findings of a systematic review of research articles that estimate the prevalence of missed and delayed diagnoses of dementia. Efforts to understand factors that contribute to missed or delayed diagnoses may result in more robust strategies to improve timely diagnoses and effective interventions. The third article attempts to differentiate the prevalence of cognitive impairment that does not progress to a diagnosis of dementia. The findings suggest that, contrary to conventional thought, not every patient with cognitive impairment will ultimately have dementia. The final article illustrates the difficulties of identifying community-dwelling older adults with dementia. Once identified, the authors determined that patients and their families have wide range of unmet needs that may be addressed with better preparation of healthcare providers. Future research may produce more robust evidence on these important topics.