Improving Dementia Care The Role Of Screening And Detection Of Cognitive Impairment
"The value of screening for cognitive impairment, including dementia and Alzheimer's disease, has been debated for decades. Recent research on causes of and treatments for cognitive impairment has converged to challenge previous thinking about screening for cognitive impairment. Consequently, changes have occurred in health care policies and priorities, including the establishment of the annual wellness visit, which requires detection of any cognitive impairment for Medicare enrollees. In response to these changes, the Alzheimer's Foundation of America and the Alzheimer's Drug Discovery Foundation convened a workgroup to review evidence for screening implementation and to evaluate the implications of routine dementia detection for health care redesign. The primary domains reviewed were consideration of the benefits, harms, and impact of cognitive screening on health care quality. In conference, the workgroup developed 10 recommendations
for realizing the national policy goals of early detection as the first step in improving clinical care and ensuring proactive, patient-centered management of dementia."
©2013 The Alzheimer's Association.
- Promote in-depth education of the public, health care providers, health care organizations, and insurers about screening for cognitive impairment and dementia, and its role in initiating high quality dementia care
- Address the public health impact of diagnostic thresholds as related to the application of screening for cognitive impairment and dementia.
- Place screening in the context of personalized health care.
- Develop further the evidence base supporting the value of formal dementia care.
- Identify and mitigate health system factors that impede high-quality care for cognitively impaired patients and their family caregivers.
- Support efforts to articulate patient- and family-centered outcomes for assessing the value of screening, case finding, and comprehensive care.
- Review health system and health plan barriers to optimal management, including lack of incentives to find patients with dementia and to develop comprehensive care plans. Educate providers about incentives to improve care, when they exist.
- Move toward a dynamic, participatory cognitive screening, surveillance, and management model facilitated by information technology.
- Define "ownership" of dementia in the layout of health care.
- Promote critical system change in health care delivery for dementia.