Authors (including presenting author) :
Ma SPM, Suen YLE, Jam PS, Lam WS, Ko MYS, Lam KPC, Chan BY, Leung SH
Affiliation :
Department of Family Medicine and General Out Patient Clinic, Kowloon Central Cluster
Introduction :
Cognitive impairment is a precursor of dementia. Early detection of cognitive impairment is an essential first step towards early diagnosis of dementia. Hong Kong has the longest life expectancy in the world, with the aging population and the increasing number of dementia, the number of cognitive impairment is expected to rise. It creates a tremendous public health, social and economic burden on the society in the coming decades. There had many studies and researches proven the benefits of early recognition of cognitive impairment. Early interventions provide early appropriate treatment and prevention. It can effectively improve their cognitive functions and daily abilities. It also enhances the quality of life of patients and their carers. With the aims of raise the public awareness of cognitive impairment, enhance the self-care and management in the early stage of cognitive impairment, “A Pilot Programme on Early Detection for Early Cognitive Impairment in GOPC” was implemented in primary care setting.
Objectives :
To enhance the quality of gerontological care in GOPC.
Methodology :
The pilot programme was target to recruit 100 patients randomly on their scheduled appointment date for screening early cognitive impairment during the period from July - August 2022 in GOPCs of KCC FM&GOPC.
Inclusion criteria includes:
(i) age above 60 with chronic follow up in GOPC
(ii) without diagnosed as Dementia/ Alzheimer’s disease
Exclusion criteria includes:
(i) having mental illness
(ii) non-communicable
(iii) diagnosed with Dementia or Alzheimer’s
The recruited patients are required to conduct a screening test before their medical consultation. The Hong Kong version of Abbreviated Mental Test (AMT) scoring system was used as a screening tool.
If a respondent AMT score is less than 8 marks, such respondent will be considered may having early cognitive impairment.
Medical Officer will follow-up the eligible persons with medical advice and refer the patients to Occupational Therapist for further cognitive assessment and training.
After medical consultation, nursing intervention will be provided to the patients +/- family carers by educating a designated pamphlet (for patient empowerment with information of early cognitive impairment). Two satisfaction questionnaires were conducted for patient to evaluate their satisfaction level after the nursing intervention and after 3 weeks in the telephone review.
Result & Outcome :
100 patients were recruited in the study, 40 male and 60 Female. The age is on average 76 years old (the youngest:61 and oldest:95).
83 patients were cognitively normal, while 17 patients had abnormal cognitive who have AMT score less than 8 marks. The 17% out of 100 recruited patients in our AMT score result match to the researches’ estimation. It stated 10% to 20% of individuals above 65 years of age will be diagnosed having the cognitive impairment.
The first questionnaire showed more than 70% of the patients satisfy to gain the knowledge of early cognitive impairment from nursing intervention and pamphlet.
For the second questionnaire, around 60% patients feedback they have continuously follow-up by the referral appointment. Nearly 50% of patients had applied the preventive methods recommended in the pamphlet.
Early detection of cognitive impairment is very important nowadays. This pilot programme identified that the AMT scoring system is an accurate screening tool that can be easily administered in a primary care setting to assist in the early detection of early cognitive impairment and help to minimize the later risk of dementia developed in the elderly. It is effective to raise awareness of cognitive impairment to elderly patients; empower patient ability of self-care and management in their early stage of cognitive impairment; and improve their quality of life.
