Abstract
Growth in aging of the population has led to increasing numbers of elderly people presenting cognitive impairment and evolution to dementia. There is still no consensus within primary care on the best strategy for screening for cognitive impairment among elderly people. Standardization of a simple but reasonably accurate instrument for a brief cognitive test, in primary care environments, would enable healthcare professionals to identify individuals who require a more in-depth assessment of cognition. To investigate the instruments used by healthcare professionals in studies conducted worldwide and ascertain the most suitable instruments for screening for cognitive impairment among individuals aged 60 years or over, in the Brazilian population. Scoping review developed at Pontifícia Universidade Católica de São Paulo, Brazil. A systematic search of the literature was conducted for primary studies using instruments to screen for cognitive impairment among individuals aged 60 years or over, in the MEDLINE, EMBASE, Cochrane Central and LILACS databases. A total of 983 articles were identified by two independent reviewers, from which 49 were selected for full-text reading, based on the criteria defined for this review. From this, 16 articles adhering to the theme of screening for cognitive impairment among the elderly were selected for in-depth analysis. The Mini-Mental State Examination was the instrument most cited in these studies. The Pfeffer Functional Activities Questionnaire and the Verbal Fluency Test (semantic category) present characteristics favoring further studies, for testing as screening instruments for cognitive impairment among elderly people in Brazil.
Highlights
Substantial increases in the numbers of elderly people are foreseen in all countries, greater growth is expected in developing regions such as Brazil, where the proportions are expected to become 18.8% in 2020 and 29.3% in 2050.1,2Primary care is considered to be the front line for healthcare for the elderly and can provide regular contacts focused on preventing disabilities resulting from chronic health conditions, such as classification of cognitive impairment in this age group.[3]Healthcare professionals are faced with the challenge of evaluating the limit of normality among elderly people’s cognitive alterations
To investigate the cognitive screening instruments used by healthcare professionals in studies conducted worldwide and ascertain which of these are most suitable for use in screening for cognitive impairment among individuals aged 60 years or over, in the Brazilian population
The criteria used for analysis in this scoping review, on the instruments that might be best suited for use in the Brazilian population, were the following: quick application, validation for use in primary care locations or in the community; adequate psychometric properties; ease of application by members of the healthcare team; the least possible influence from the subject’s educational and cultural level; and whether elderly people’s interest in the evaluation was aroused
Summary
Substantial increases in the numbers of elderly people are foreseen in all countries, greater growth is expected in developing regions such as Brazil, where the proportions are expected to become 18.8% in 2020 and 29.3% in 2050.1,2Primary care is considered to be the front line for healthcare for the elderly and can provide regular contacts focused on preventing disabilities resulting from chronic health conditions, such as classification of cognitive impairment in this age group.[3]Healthcare professionals are faced with the challenge of evaluating the limit of normality among elderly people’s cognitive alterations. Growth in aging of the population has led to increasing numbers of elderly people presenting cognitive impairment and evolution to dementia. OBJECTIVES: To investigate the instruments used by healthcare professionals in studies conducted worldwide and ascertain the most suitable instruments for screening for cognitive impairment among individuals aged 60 years or over, in the Brazilian population. METHOD: A systematic search of the literature was conducted for primary studies using instruments to screen for cognitive impairment among individuals aged 60 years or over, in the MEDLINE, EMBASE, Cochrane Central and LILACS databases. The Pfeffer Functional Activities Questionnaire and the Verbal Fluency Test (semantic category) present characteristics favoring further studies, for testing as screening instruments for cognitive impairment among elderly people in Brazil
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