Mild Cognitive Impairment (MCI), Dementia, Cognitive impairment, Frailty Lichte cognitieve stoornissen, dementie, kwetsbaarheid
Conditions
Interventions
The intervention in this study was developed by our project team comprising several FPs and in close collaboration with three FPs participating in the study. It is aimed at individuals classified as h
2. Screening and diagnosis in individual
Sponsors
VU UNiversity Medical Center, EMGO Institute for Health and Care Research
Eligibility
Inclusion criteria
Inclusion criteria: Individuals > 65 years in whom family physicians suspect cognitive impairment.
Exclusion criteria
Exclusion criteria: 1. Patient with FP or specialist diagnosis 'probable dementia'; 2. Patient or informal caregiver terminally ill; 3. Permanent admission to a nursing home expected within 6 months; 4. Not sufficiently capable of understanding spoken language or expressing him- or herself.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The primary comparison between intervention and control PCPs is the number of incident MCI and dementia diagnoses after 12 months, in individuals already suspected of developing cognitive problems by their FP. This is operationalized as follows: All FPs are asked to again classify the cognitive status of individuals enrolled in the RCT, 1 year after the start of the intervention. This time, we ask them to categorise them as either: 1. No MCI or dementia; 2. MCI; 3. Dementia syndrome. FPs are asked to indicate whether they explicitly disclosed the diagnosis to the individual with cognitive impairment and his or her informal caregiver. In addition to this, we will check the medical records, including medical correspondence, for specialist and FP dementia diagnoses. We chose to make FPs classification after 1 year leading as we assume that, particularly in the control group, documentation of the cognitive status in the medical records is limited. Thus, when an individual is classified as having dementia we will regard it an incident case even when it is not documented as such is the medical records. If an individual is classified as not having dementia but the medical records suggest there may be dementia we will check again with the FP. Validation of FP MCI and dementia diagnosis: FPs MCI and dementia diagnosis will be compared to a reference standard diagnosis of cognitive status The reference standard used is the CAMCOG, the cognitive assessment part of the Cambridge Examination for Mental Disorders for the Elderly. We use the complete CAMCOG and the memory section of the CAMCOG to distinguish: 1) normal cognitive function for age, 2) MCI and 3) dementia. It will be administered to all participants at baseline and at 1 year follow-up. We chose the CAMCOG because it is relatively brief and easy to administer but still has good psychometric properties and because it allows distinguishing normal ageing, MCI and dementia[Schmand 2000]. | — |
Secondary
| Measure | Time frame |
|---|---|
| Secondary we will compare the quality of life and mental health of individuals with MCI or dementia and their informal carers between intervention and control group. Earlier identification of MCI and dementia and subsequent collaborative care may be beneficial but may also have negative effects. We will explore these effects in the intervention and control group after 1 year. For the instruments used to measure these outcomes we considered good feasibility, validity, reliability, responsiveness and international use important. Furthermore, we will explore individuals preference regarding cognitive testing and disclosure of MCI and dementia diagnoses. | — |
Contacts
Public ContactP. Dungen, van den
Van der Boechorstraat 7
Outcome results
None listed