Pilot Evaluation of the Informant AD8 as a Case-Finding Instrument for Cognitive Impairment in General Practitioner Clinics of Singapore: A Brief Report

J Am Med Dir Assoc. 2016 Dec 1;17(12):1147-1150. doi: 10.1016/j.jamda.2016.07.031.

Abstract

Background: Case-finding services using a composite total risk score (TRS) and the informant AD8 have been previously recommended to detect cognitive impairment (CI) in government subsidized primary health care centers of Singapore (ie, polyclinics).

Objective: We compared the feasibility of implementing the services recommended for government-subsidized primary health care in private, primary health care service providers such as general practitioner (GP) clinics.

Method: 123 patients ≥60 years of age were recruited from 2 GP clinics within Singapore. Trained research personnel administered the AD8 to informants. Patients of the present study were compared against a random sample of 123 patients selected from polyclinics.

Results: Significantly higher positive screening rates (AD8 ≥3) were found among patients in polyclinics than GP clinics (P < .001). Patients attending polyclinics reported more comorbid medical issues such as subjective cognitive complaint (P < .001) and heart disease (P < .001). The TRS of patients attending polyclinics was significantly higher than those attending GP clinics (P < .001), indicating a higher proportion of patients at risk of CI in polyclinics. Therefore, patients attending polyclinics were found to have higher AD8 scores compared with patients in GP clinics (P < .001).

Conclusion: Compared with GP clinics, polyclinics may be more suited to provide case-finding services for the detection of CI in primary health care.

Keywords: Case finding; cognitive screening; dementia; primary care.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Cognition Disorders / diagnosis*
  • Feasibility Studies
  • Female
  • General Practitioners*
  • Humans
  • Information Storage and Retrieval*
  • Male
  • Middle Aged
  • Neuropsychological Tests
  • Pilot Projects
  • Primary Health Care*
  • Singapore