Abstract
Background and Objective. Detection rates of hypertension continues to be suboptimal worldwide. The risk of hypertension increases substantially in older adults aged ≥65 years, a group also at increased risk of atrial fibrillation (AF), cognitive decline and hearing loss—all factors associated with hypertension. This pilot study aimed to 1) implement a combined screening strategy for these health conditions, and 2) assess feasibility and acceptability of the combined screening. Methods. Adults aged ≥65 years without a prior diagnosis of cognitive impairment and dementia were invited to attend a combined screening appointment through advertisements posted in university and community group newsletters and noticeboards. Participants underwent blood pressure (BP) and AF screening using an oscillometric BP monitor with AF detection (Microlife WatchBP Office 2G), cognitive assessment (General Practitioner Assessment of Cognition, GPCOG), and audiometric testing. A subset of participants was invited to participate in a post-study process evaluation interview. Results. Of the 35 participants (age 73±6 years, 51% females), 26 (74%) had hypertension (on antihypertensive medication: n=20; measured: n=6; unaware: n=2; uncontrolled: n=4). Possible AF was detected in two participants and seven had possible cognitive decline (GPCOG score <9). Hearing loss was detected in 13 participants. Interviews (n=16, 50% females) revealed that combined screening was acceptable and feasible as participants felt it was “convenient”, “saves time”, “a brilliant idea”, and that “… conditions are related and therefore appropriate to be together”. Most participants were already aware of their hypertension status, thus screening did not result in increased hypertension awareness except for one with uncontrolled hypertension who proceeded to purchase a home BP monitor. One participant with detected AF visited a cardiologist and confirmed non-AF arrhythmia. All interviewees found the appointment duration (approximately 60-75 minutes) was not too long nor too taxing. Conclusions. Combined screening in older adults with increased cardiovascular risk is feasible and acceptable and should be considered for future screening programs in older adults.
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