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Targeted case finding for dementia in primary care: Surrey Downs dementia diagnosis project

Currently less than half of the estimated number of people with dementia in England receive a formal diagnosis of dementia or have contact with specialist dementia services. Case finding focused on high risk groups may be an effective way to identify the undiagnosed. This joint Surrey Downs Clinical...

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Autores principales: Kallumpuram, Sen, Sudhir Kumar, CT, Khan, Bilal, Gavins, Victoria, Khan, Aalia, Iliffe, Steve
Formato: Online Artículo Texto
Lenguaje:English
Publicado: British Publishing Group 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4752712/
https://www.ncbi.nlm.nih.gov/pubmed/26893884
http://dx.doi.org/10.1136/bmjquality.u209827.w4086
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author Kallumpuram, Sen
Sudhir Kumar, CT
Khan, Bilal
Gavins, Victoria
Khan, Aalia
Iliffe, Steve
author_facet Kallumpuram, Sen
Sudhir Kumar, CT
Khan, Bilal
Gavins, Victoria
Khan, Aalia
Iliffe, Steve
author_sort Kallumpuram, Sen
collection PubMed
description Currently less than half of the estimated number of people with dementia in England receive a formal diagnosis of dementia or have contact with specialist dementia services. Case finding focused on high risk groups may be an effective way to identify the undiagnosed. This joint Surrey Downs Clinical Commissioning Group and Surrey and Borders NHS Foundation Trust quality improvement project aimed to increase the rate of dementia diagnosis across Surrey Downs using specialist link nurses (SLNs). Thirty three GP surgeries covering the entire Surrey Downs area took part in the project. Individuals at high risk of developing dementia were identified from GP electronic disease registers, and were offered screening at their GP practices by SLNs, using a combination of mini cognitive test (Mini-Cog) and functional assessment questionnaire (FAQ). Suitable individuals who screened positive were seen by their GP and where appropriate referred to secondary care services for further evaluation. Based on the presence of risk factors, 6657 (11.9%) people were identified from a total population of 55 845 over 65s, and 1980 (29.7%) completed the screening assessment. Three hundred and fifty eight (18.1%) individuals screened positive and were referred to their GP, who referred 205 (57.2%) of them to the memory services for further assessment. Of those referred, 164 (80%) had a comprehensive specialist assessment. Forty one (20%) declined further assessment, and their GPs were informed. The mean age of the cohort who completed the comprehensive assessment was 82.3 years (SD=4.26), and were predominantly white and male. Fifty four (32.9%) had mild cognitive disorder (MCD), and 101 (61.6%) patients were diagnosed with dementia. The most common dementia was mixed type (43; 42.6%), followed by Alzheimer's dementia (32; 31.7%). The most common risk factor among patients with cognitive impairment (MCD or dementia) was hypertension (69; 44.5 %), followed by ischemic heart disease (64, 41.3%). Nurse led case finding for cognitive impairment in a high risk population identifies people with dementia who are not yet formally diagnosed. The combined use of brief instruments to assess cognitive functioning and functional capabilities is helpful in identifying individuals with possible dementia.
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spelling pubmed-47527122016-02-18 Targeted case finding for dementia in primary care: Surrey Downs dementia diagnosis project Kallumpuram, Sen Sudhir Kumar, CT Khan, Bilal Gavins, Victoria Khan, Aalia Iliffe, Steve BMJ Qual Improv Rep BMJ Quality Improvement Programme Currently less than half of the estimated number of people with dementia in England receive a formal diagnosis of dementia or have contact with specialist dementia services. Case finding focused on high risk groups may be an effective way to identify the undiagnosed. This joint Surrey Downs Clinical Commissioning Group and Surrey and Borders NHS Foundation Trust quality improvement project aimed to increase the rate of dementia diagnosis across Surrey Downs using specialist link nurses (SLNs). Thirty three GP surgeries covering the entire Surrey Downs area took part in the project. Individuals at high risk of developing dementia were identified from GP electronic disease registers, and were offered screening at their GP practices by SLNs, using a combination of mini cognitive test (Mini-Cog) and functional assessment questionnaire (FAQ). Suitable individuals who screened positive were seen by their GP and where appropriate referred to secondary care services for further evaluation. Based on the presence of risk factors, 6657 (11.9%) people were identified from a total population of 55 845 over 65s, and 1980 (29.7%) completed the screening assessment. Three hundred and fifty eight (18.1%) individuals screened positive and were referred to their GP, who referred 205 (57.2%) of them to the memory services for further assessment. Of those referred, 164 (80%) had a comprehensive specialist assessment. Forty one (20%) declined further assessment, and their GPs were informed. The mean age of the cohort who completed the comprehensive assessment was 82.3 years (SD=4.26), and were predominantly white and male. Fifty four (32.9%) had mild cognitive disorder (MCD), and 101 (61.6%) patients were diagnosed with dementia. The most common dementia was mixed type (43; 42.6%), followed by Alzheimer's dementia (32; 31.7%). The most common risk factor among patients with cognitive impairment (MCD or dementia) was hypertension (69; 44.5 %), followed by ischemic heart disease (64, 41.3%). Nurse led case finding for cognitive impairment in a high risk population identifies people with dementia who are not yet formally diagnosed. The combined use of brief instruments to assess cognitive functioning and functional capabilities is helpful in identifying individuals with possible dementia. British Publishing Group 2015-12-09 /pmc/articles/PMC4752712/ /pubmed/26893884 http://dx.doi.org/10.1136/bmjquality.u209827.w4086 Text en © 2016, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/http://creativecommons.org/licenses/by-nc/2.0/legalcode
spellingShingle BMJ Quality Improvement Programme
Kallumpuram, Sen
Sudhir Kumar, CT
Khan, Bilal
Gavins, Victoria
Khan, Aalia
Iliffe, Steve
Targeted case finding for dementia in primary care: Surrey Downs dementia diagnosis project
title Targeted case finding for dementia in primary care: Surrey Downs dementia diagnosis project
title_full Targeted case finding for dementia in primary care: Surrey Downs dementia diagnosis project
title_fullStr Targeted case finding for dementia in primary care: Surrey Downs dementia diagnosis project
title_full_unstemmed Targeted case finding for dementia in primary care: Surrey Downs dementia diagnosis project
title_short Targeted case finding for dementia in primary care: Surrey Downs dementia diagnosis project
title_sort targeted case finding for dementia in primary care: surrey downs dementia diagnosis project
topic BMJ Quality Improvement Programme
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4752712/
https://www.ncbi.nlm.nih.gov/pubmed/26893884
http://dx.doi.org/10.1136/bmjquality.u209827.w4086
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