Neurocognitive Disorders
Conditions
Keywords
Dementia, Dementia screening, General Hospital, Inpatients
Brief summary
Neurocognitive Disorder (NCD) affects over 116'000 people in Switzerland and is frequently unrecognized and underdiagnosed. Because missed and delayed diagnosis are associated with an increased burden of disease health Service Research has prompted a discussion about diagnostic guidelines and screening programs. Some argue that screening for NCD in primary care is the optimal strategy to increase recognition rates; others consider test protocols implemented into hospital admission assessments as more justified. There is no distinct recommendation due to a lack of empirical data on the benefits and harms of cognitive testing yet. This trial strives to fill this gap and provide information about the benefits, harms and the economic case of routine cognitive testing for neurocognitive disorder in high risk elective inpatients, in Switzerland. The investigators hypothesize that, cognitive tested patients, compared with patients not cognitive tested, will have higher health-related quality of life at 12months; and lower medical health care costs at 18months.
Interventions
OTHERBRAINCHECK
Subjects of the Intervention-Group will undergo a brief cognitive assessment, using the BRAINCHECK, during hospital admission assessments. Subjects with positive results will then be referred to a Memory Clinic undergoing subsequent interdisciplinary comprehensive diagnostic examinations. Patients with established diagnosis will be invited to counselling services of the Alzheimer Association (providing social counselling).
Sponsors
Universität Luzern
Luzerner Kantonsspital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Elective inpatients, living in the canton of lucerne, high risk of developing a major neurocognitive disorder, living at home
Exclusion criteria
* Known mental disorder according to ICD-10, chapter V, excluding F32 & F33, patients with terminal illness, patients of intensive care unit or oncology patients, no adequate vision or hearing, no ability to speak, write or to understand German, no Informant, antidementia medication
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Health related quality of life (HRQoL) | every month during 18months | Patient and Caregiver, using EuroQol 5D-5L |
| Health Service Resource Utilization / Costs | every month during 18months | Patient and Caregiver, using Resource Utilization in Dementia (RUD) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| prevalence of neurocognitive disorder | baseline/6months | at Hospital admission |
| prevalence of risk factors associated with developing major neurocognitive disorder within 6 years | baseline/6months | at Hospital Admission, using Brief Dementia Screening Indicator (BDSI) |
Other
| Measure | Time frame | Description |
|---|---|---|
| hospital anxiety and depression | every 3 months | patient and caregiver data, using Hospital Anxiety and Depression Scale (HADS) |
| caregiver burden | every 3 months | caregiver data, short Zarit Burden Interview (ZBI) |
| severity of cognitive impairment | every 6 months | patients of the Intervention-Group will be assessed every months, using the Montreal Cognitive Assessment (MOCA) |
| adverse events/adverse outcomes | between baseline and 6months | falls, delirium, mortality, mortality within 30 days of discharge, re-admission within 18 days, institutionalization following hospitalization, length of stay |
| comorbidities | baseline | patient data, using Charlson Comorbidity Index |
| neuropsychiatric symptoms | between baseline and 6months | patient data during Hospital stay, using Neuropsychiatric Inventory Questionnaire (NPI-Q) |
Countries
Switzerland
Outcome results
None listed