[Brain check-up: a structured approach diagnosing mild cognitive impairment in the primary care setting].

IF 1.1 4区 医学 Q4 GERIATRICS & GERONTOLOGY Zeitschrift Fur Gerontologie Und Geriatrie Pub Date : 2024-06-05 DOI:10.1007/s00391-024-02319-y
Lucas Wolski, Ann-Kathrin Bopp, Ann-Kathrin Schwientek, Sandra Langer, Vildan Dogan, Timo Grimmer
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Abstract

Background: The reason-related identification of mild cognitive impairment (MCI) in primary care is helpful to treat reversible causes or decelerate progression to dementia by optimal management of existing risk factors. In this process general practitioners are in a key position. The present feasibility study investigated the practicability of a diagnostic algorithm (brain check-up), comprising neuropsychological examinations, differential diagnoses and follow-up measures.

Method: By means of a standardized questionnaire, the utilization and practicability of the brain check-up was surveyed in n = 37 medical practices of general practitioners and internists in Germany.

Results: The brain check-up was performed by n = 37 physicians in 389 patients (66%). The main barriers to implementation included patients' fear of facing the results, the professionals' lack of time, and costs. Overall, 73% of the participants agreed that the brain check-up was practical in everyday treatment. Long waiting times for an appointment with a neurological/psychiatric specialist were perceived as a barrier for optimal care.

Conclusion: The structured algorithm is convenient in physician's everyday practice and can contribute to identify patients with MCI more easily. Therefore, it appears to be a helpful tool in primary care. To achieve sustainability in everyday use, identified barriers need to be addressed during the implementation phase.

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[脑部检查:在基层医疗机构诊断轻度认知障碍的结构化方法]。
背景:在初级保健中对轻度认知功能障碍(MCI)进行与原因相关的识别,有助于治疗可逆转的病因,或通过对现有风险因素的优化管理来延缓痴呆症的发展。在这一过程中,全科医生处于关键地位。本可行性研究调查了由神经心理学检查、鉴别诊断和后续措施组成的诊断算法(脑部检查)的实用性:方法:通过标准化问卷,对德国 n = 37 家全科医生和内科医生诊所的脑部检查使用情况和实用性进行了调查:结果:37 名医生对 389 名患者(66%)进行了脑部检查。实施的主要障碍包括患者害怕面对检查结果、专业人员缺乏时间和费用。总体而言,73% 的参与者认为脑部检查在日常治疗中非常实用。与神经科/精神科专家预约的等待时间过长被认为是实现最佳治疗的障碍:结构化算法方便了医生的日常工作,有助于更容易地识别 MCI 患者。因此,它似乎是初级保健中的一个有用工具。为了在日常使用中实现可持续性,需要在实施阶段解决已发现的障碍。
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来源期刊
CiteScore
2.00
自引率
16.70%
发文量
126
审稿时长
6-12 weeks
期刊介绍: The fact that more and more people are becoming older and are having a significant influence on our society is due to intensive geriatric research and geriatric medicine in the past and present. The Zeitschrift für Gerontologie und Geriatrie has contributed to this area for many years by informing a broad spectrum of interested readers about various developments in gerontology research. Special issues focus on all questions concerning gerontology, biology and basic research of aging, geriatric research, psychology and sociology as well as practical aspects of geriatric care. Target group: Geriatricians, social gerontologists, geriatric psychologists, geriatric psychiatrists, nurses/caregivers, nurse researchers, biogerontologists in geriatric wards/clinics, gerontological institutes, and institutions of teaching and further or continuing education.
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Mitteilungen der DGG. Mitteilungen der DGGG. Mitteilungen der ÖGGG. Mitteilungen des BV Geriatrie. [Human dignity and autonomy in medicoethical decisions at the end of life].
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