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One Size Does Not Fit All: Choosing Practical Cognitive Screening Tools for Your Practice.

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Free cognitive screening tools face accessibility issues due to a "free-to-fee" cycle. Recommendations include developing toolkits of permanently free, validated tools and using the new PRACTICAL.1 Criteria for selection.

Keywords:
Montreal Cognitive Assessmentcognitiondementiascreeningtests

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Area of Science:

  • Geriatrics
  • Cognitive Neurology
  • Health Services Research

Background:

  • Millions undergo cognitive testing annually, but access to free tools is increasingly unstable.
  • The Mini-Mental State Examination and Montreal Cognitive Assessment have associated costs, limiting accessibility.
  • A
  • free-to-fee
  • cycle emerges where initially free tools become monetized, forcing clinicians to seek alternatives.

Purpose of the Study:

  • To outline the disruptive "free-to-fee" cycle affecting free open access cognitive screening tools.
  • To provide recommendations for breaking this cycle and ensuring sustained accessibility.
  • To introduce the PRACTICAL.1 Criteria for selecting validated, accessible cognitive screening tools.

Main Methods:

  • Analysis of the emerging "free-to-fee" cycle in cognitive screening tool accessibility.
  • Development of the PRACTICAL.1 Criteria (PRACTIcing Clinician Accessibility and Logistical Criteria Version 1) for tool selection.
  • Discussion of methodological issues, training needs, and ethnolinguistic diversity in cognitive screening.

Main Results:

  • The "free-to-fee" cycle creates barriers to consistent use of valuable cognitive screening tools.
  • The PRACTICAL.1 Criteria offer a framework for clinicians to evaluate and select appropriate tools based on accessibility and logistical factors.
  • Recommendations include creating toolkits of permanently free, validated tools and embedding PRACTICAL.1 Criteria in future reviews.

Conclusions:

  • Breaking the "free-to-fee" cycle is crucial for equitable access to cognitive screening.
  • The PRACTICAL.1 Criteria provide a practical solution for clinicians navigating tool selection.
  • Future efforts should prioritize open access, user training, and cultural/linguistic adaptability in cognitive screening tools.