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Routine cognitive screening in a neurology practice: Effect on physician behavior.

Michael Rosenbloom1, Soo Borson1, Terry Barclay1

  • 1HealthPartners Center for Memory and Aging (MR, TB, LRH), St. Paul; Department of Neurology (MR, JM), University of Minnesota Medical School, Minneapolis; Geriatric Research, Education and Clinical Center (GRECC) (JM), Minneapolis VA Health Care System, MN; the University of Washington School of Nursing (SB), University of Washington School of Medicine, Seattle; and HealthPartners Institute for Research and Education (LRH, AW, LS), Bloomington, MN.

Neurology. Clinical Practice
|February 27, 2016
PubMed
Summary

A pilot study using the Mini-Cog cognitive screening tool in neurology patients aged 70+ found that screening positive significantly increased follow-up assessments and diagnoses of cognitive impairment or dementia.

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Area of Science:

  • Neurology
  • Geriatrics
  • Cognitive Science

Background:

  • Alzheimer disease is a leading neurologic disorder with significant costs.
  • Current guidelines lack specific cognitive screening recommendations for dementia.
  • Early detection of cognitive impairment is crucial for timely intervention.

Purpose of the Study:

  • To evaluate the effectiveness of a cognitive screening initiative using the Mini-Cog in a neurology setting.
  • To assess the impact of Mini-Cog screening on subsequent diagnostic and treatment pathways for cognitive impairment.

Main Methods:

  • A pilot program administered the Mini-Cog to neurology patients aged 70 and older without a prior cognitive disorder diagnosis.
  • Screening results were prospectively analyzed over an 18-month period.

Main Results:

  • The Mini-Cog identified cognitive impairment in 37.4% of patients.
  • Patients screening positive were significantly more likely to receive follow-up cognitive assessment, neuropsychological testing, and a diagnosis of cognitive impairment or dementia.
  • However, diagnosis rates and treatment actions did not exceed those seen in primary care screening trials.

Conclusions:

  • Cognitive screening with the Mini-Cog in neurology settings can increase diagnostic evaluations.
  • Further research is needed to optimize neurologist actions in managing cognitive impairment identified through screening.