Transcript Prevalence of Cognitive Impairment in a

Prevalence of Cognitive Impairment in a
Community Dwelling Elderly Population in
Aberdeen City
Dr Peter Watson, Links Medical Practice, Aberdeen
2013
Identify Patients –
over 75, registered
with Links medical
practice
Introduction
In June 2010, the Scottish Government identified
dementia care as a priority with the publication of
Scotland’s National Dementia Strategy. One of its
priorities is to improve the level of diagnosis of dementia.
As of August 2011, the number of people on NHS
Grampian’s Dementia Register was equivalent to only
55% of the predicted prevalence. One factor might be the
recent cessation of annual routine visits by community
nurses to the over 75 population, one component of this
visit being the Abbreviated mental Test.
Exclude those
known to have
dementia
Letter sent to
patient from GP
practice
Do not wish to be
involved
Excluded
Nurse contacts
those remaining by
telephone
No answer to
telephone
Try telephone
number again on a
different
day/different time
of day
Aim
The aim of this project is to assess the feasibility of
measuring the prevalence of cognitive impairment in
persons living in the community in Aberdeen City aged 75
and above, registered with Links Medical practice.
Telephone
conversation
with patient explain project
and offer time to
visit
If no telephone, or
no available
number, letter
written to offer
time to visit
Home visit: Explain process and seek
informed consent
Do not wish to be
involved or
informed consent
could not be
obtained
Still no answer to
telephone
Exclude those
open to
psychiatry
Informed consent
obtained – AMT and
HADS administered, and
demographic details
obtained
Excluded
Excluded
Appointment made
with GP at Links
Medical Practice –
other causes ruled
out/cognitive
impairment
confirmed
Less than 8 on
AMT or more
than 7 on either
subscale of HADS
No impairment
noted
Feedback to
GP practice
with patients
consent
Further assessment by old
age psychiatry if required
Methods
All patients in the practice over 75 and above will be
identified. All those on the dementia register and those
already open to old age psychiatry will be excluded. The
flow chart explains the methodology.
Results
The project is just at the very early stages. 40 patients
have had a written invite of whom 20 have been assessed.
Learning Points from the Scholarship
•Diagnosis
•Drug and non drug management
•Job shadowing with secondary care colleagues
•Role of Statutory Agencies & Third Sector
•Legal Aspects including Capacity
•The most important of these has been the
opportunity to network with and learn from
colleagues across the whole health and social
care spectrum.