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How to choose the most appropriate cognitive test to evaluate cognitive complaints in primary care
BACKGROUND: Despite the wealth of research devoted to the performance of individual cognitive tests for diagnosing cognitive impairment (including mild cognitive impairment and dementia), it can be difficult for general practitioners to choose the most appropriate test for a patient with cognitive c...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5732477/ https://www.ncbi.nlm.nih.gov/pubmed/29246193 http://dx.doi.org/10.1186/s12875-017-0675-4 |
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author | Janssen, Jolien Koekkoek, Paula S. Moll van Charante, Eric P. Jaap Kappelle, L. Biessels, Geert Jan Rutten, Guy E. H. M. |
author_facet | Janssen, Jolien Koekkoek, Paula S. Moll van Charante, Eric P. Jaap Kappelle, L. Biessels, Geert Jan Rutten, Guy E. H. M. |
author_sort | Janssen, Jolien |
collection | PubMed |
description | BACKGROUND: Despite the wealth of research devoted to the performance of individual cognitive tests for diagnosing cognitive impairment (including mild cognitive impairment and dementia), it can be difficult for general practitioners to choose the most appropriate test for a patient with cognitive complaints in daily practice. In this paper we present a diagnostic algorithm for the evaluation of cognitive complaints in primary care. The rationale behind this algorithm is that the likelihood of cognitive impairment -which can be determined after history taking and an informant interview- should determine which cognitive test is most suitable. METHODS: We distinguished three likelihoods of cognitive impairment: not likely, possible or likely. We selected cognitive tests based on pre-defined required test features for each of these three situations and a review of the literature. We incorporated the cognitive tests in a practical diagnostic algorithm. RESULTS: Based on the available literature, in patients with complaints but where cognitive impairment is considered to be unlikely the clock-drawing test can be used to rule out cognitive impairment. When cognitive impairment is possible the Montreal cognitive assessment can be used to rule out cognitive impairment or to make cognitive impairment more likely. When cognitive impairment is likely the Mini-Mental State Examination can be used to confirm the presence of cognitive impairment. CONCLUSIONS: We propose a diagnostic algorithm to increase the efficiency of ruling out or diagnosing cognitive impairment in primary care. Further study is needed to validate and evaluate this stepwise diagnostic algorithm. |
format | Online Article Text |
id | pubmed-5732477 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-57324772017-12-21 How to choose the most appropriate cognitive test to evaluate cognitive complaints in primary care Janssen, Jolien Koekkoek, Paula S. Moll van Charante, Eric P. Jaap Kappelle, L. Biessels, Geert Jan Rutten, Guy E. H. M. BMC Fam Pract Research Article BACKGROUND: Despite the wealth of research devoted to the performance of individual cognitive tests for diagnosing cognitive impairment (including mild cognitive impairment and dementia), it can be difficult for general practitioners to choose the most appropriate test for a patient with cognitive complaints in daily practice. In this paper we present a diagnostic algorithm for the evaluation of cognitive complaints in primary care. The rationale behind this algorithm is that the likelihood of cognitive impairment -which can be determined after history taking and an informant interview- should determine which cognitive test is most suitable. METHODS: We distinguished three likelihoods of cognitive impairment: not likely, possible or likely. We selected cognitive tests based on pre-defined required test features for each of these three situations and a review of the literature. We incorporated the cognitive tests in a practical diagnostic algorithm. RESULTS: Based on the available literature, in patients with complaints but where cognitive impairment is considered to be unlikely the clock-drawing test can be used to rule out cognitive impairment. When cognitive impairment is possible the Montreal cognitive assessment can be used to rule out cognitive impairment or to make cognitive impairment more likely. When cognitive impairment is likely the Mini-Mental State Examination can be used to confirm the presence of cognitive impairment. CONCLUSIONS: We propose a diagnostic algorithm to increase the efficiency of ruling out or diagnosing cognitive impairment in primary care. Further study is needed to validate and evaluate this stepwise diagnostic algorithm. BioMed Central 2017-12-16 /pmc/articles/PMC5732477/ /pubmed/29246193 http://dx.doi.org/10.1186/s12875-017-0675-4 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Janssen, Jolien Koekkoek, Paula S. Moll van Charante, Eric P. Jaap Kappelle, L. Biessels, Geert Jan Rutten, Guy E. H. M. How to choose the most appropriate cognitive test to evaluate cognitive complaints in primary care |
title | How to choose the most appropriate cognitive test to evaluate cognitive complaints in primary care |
title_full | How to choose the most appropriate cognitive test to evaluate cognitive complaints in primary care |
title_fullStr | How to choose the most appropriate cognitive test to evaluate cognitive complaints in primary care |
title_full_unstemmed | How to choose the most appropriate cognitive test to evaluate cognitive complaints in primary care |
title_short | How to choose the most appropriate cognitive test to evaluate cognitive complaints in primary care |
title_sort | how to choose the most appropriate cognitive test to evaluate cognitive complaints in primary care |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5732477/ https://www.ncbi.nlm.nih.gov/pubmed/29246193 http://dx.doi.org/10.1186/s12875-017-0675-4 |
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