Health & Medical Anti Aging

Dementia Screening in Primary Care

Dementia Screening in Primary Care

Is There Evidence Supporting the Benefit of Early Implementation of Best-practice Dementia Care in Screening-detected Cases of Dementia?


In 2006, the results of a randomized controlled trial that tested the efficacy of a collaborative care model that delivered best practice dementia care were reported. Over 12 months, intervention participants received care management from an interdisciplinary team led by a nurse practitioner serving as a care coordinator who worked with individuals' family caregivers and integrated within primary care. The team used standard protocols to identify, monitor, and treat behavioral and psychological symptoms of dementia (BPSDs). At 12 and 18 months, intervention participants had fewer BPSDs, and intervention caregivers reported improvements in distress and depression, but there are no data to demonstrate that providing the collaborative dementia care model to screening-detected individuals with dementia leads to better outcomes than providing this model to individuals with recognized dementia in primary care.

In 2009, with support from the National Institutes of Health (NIH), an interdisciplinary implementation team from Indiana University Center for Aging Research and the urban safety net healthcare system in Indianapolis implemented the collaborative dementia care model. The team used the lens of complex adaptive system theory and the tools of the reflective adaptive process to translate the collaborative models into a locally sensitive program, called the Aging Brain Care (ABC) Program. The ABC Program includes a clinical team that has an advanced practice nurse as the care coordinator, a medical assistant as a care coordinator assistant, and a social worker. A medical director supervises these providers, and care coordination support software is used. Serving individuals with recognized dementia, the ABC Program improved access for participants and informal caregivers, improved participant satisfaction with care, enhanced quality of dementia care, and reduced use of acute care.

Although the efficacy of the collaborative dementia care model has been demonstrated, and it was possible to implement it within the safety net healthcare system, the generalizability and sustainability of this model in other healthcare systems has not been tested, and the benefit of this model in screening-detected individuals with dementia has not been demonstrated. Thus, the value, including harms and benefits, of screening populations of asymptomatic older adults for dementia in an attempt to identify the disease at its earliest manifestations remains controversial.

To fill this gap in the literature, funding was received from the NIH to conduct a randomized controlled dementia screening trial to obtain new knowledge to judge the benefits and potential harms of early exposure to the collaborative dementia care model through screening. The trial will randomize 4,000 adults aged 65 and older into a no screening group or a dementia screening, diagnosis, and management group. To fully explore the potential benefits and harms of dementia screening, the trial will provide subjects randomized into the screening arm with the resources of the ABC Program, which will conduct a diagnostic assessment of individuals with positive screening results, deliver the collaborative care model for those with a confirmed dementia diagnosis, and counsel and follow-up those with positive screening results but without evidence of dementia. The primary aims of the trial are to test the effect of dementia screening on the health-related quality of life, mood, and anxiety of the individual at 1, 6, and 12 months. The trial will also estimate the cost effectiveness of dementia screening (Figure 1).



(Enlarge Image)



Figure 1.



The design of randomized dementia screening trial in primary care.





SHARE
RELATED POSTS on "Health & Medical"
Tips on How to Delay Aging on Your Eye Area
Tips on How to Delay Aging on Your Eye Area
The Key To Anti-Ageing
The Key To Anti-Ageing
Aging - The Brain and Diet
Aging - The Brain and Diet
Ageing and Your Beauty Tips in Urdu
Ageing and Your Beauty Tips in Urdu
Dark Circles Under Eyes Truth - What Should You Do?
Dark Circles Under Eyes Truth - What Should You Do?
The Pros and Cons of the Best Wrinkle Removal Procedures
The Pros and Cons of the Best Wrinkle Removal Procedures
Secret Principles of Immortality, Edition 18
Secret Principles of Immortality, Edition 18
How To Look And Feel 25 Years Younger
How To Look And Feel 25 Years Younger
Simple Ways To Make Aging More Fun!
Simple Ways To Make Aging More Fun!
Getting Older: Tips For Keeping Yourself Young
Getting Older: Tips For Keeping Yourself Young
Growth Hormone Anti Aging Benefits - Turn Back Your Body Clock with HGH
Growth Hormone Anti Aging Benefits - Turn Back Your Body Clock with HGH
Genuine Pearl Powder - The Secret To Longevity And Flawless Skin
Genuine Pearl Powder - The Secret To Longevity And Flawless Skin
Facts On Hydroxatone Ingredients
Facts On Hydroxatone Ingredients
8 Proved Steps You Should Try,To Keep a Check On Acne Vulgaris
8 Proved Steps You Should Try,To Keep a Check On Acne Vulgaris
Choosing How to Age
Choosing How to Age
Anti Aging Skin Serum: How Is It Better Than a Cream?
Anti Aging Skin Serum: How Is It Better Than a Cream?
Pebble Beach, CA: Monterey Judge Gives Elder Abuser 35 Years In Prison: View From A Private Duty Car
Pebble Beach, CA: Monterey Judge Gives Elder Abuser 35 Years In Prison: View From A Private Duty Car
Guide In Choosing Effective And Easy To Use Anti Aging Moisturizers
Guide In Choosing Effective And Easy To Use Anti Aging Moisturizers
Look 10 Years Younger Naturally Without Cosmetic Procedure
Look 10 Years Younger Naturally Without Cosmetic Procedure
Is There Any Deep Wrinkle Cream That Works - Find Out the Truth Right Here
Is There Any Deep Wrinkle Cream That Works - Find Out the Truth Right Here

Leave Your Reply

*