8 Minutes to Screen for Cognitive Impairment in Primary Care

TOPLINE:
Screening older adults for cognitive impairment in primary care with the Montreal Cognitive Assessment (MoCA) is feasible and commonly identifies mild impairment.
METHODOLOGY:
Investigators conducted a prospective cohort study among 61 general practitioners (GPs) in France, most of whom had not previously used the MoCA.
The GPs administered the test to 221 patients aged 50 years and older (mean age, 66 years) without known impairment during routine consultations.
The main outcome was MoCA feasibility, defined as completion in less than 15 minutes, the average time required to complete the alternate Mini Mental State Examination.
TAKEAWAY:
On an average, the GPs completed MoCA administration in just 8 minutes (range, 5-30 minutes).
Fully, 82% of the tests were completed in 10 minutes and 97% in less than 15 minutes.
On the basis of MoCA score, 62% of screened patients had mild cognitive impairment (18-25 points) and 4% had moderate cognitive impairment (10-17 points), while the rest had normal cognition.
Most GPs reported that using the MoCA was a positive experience, in particular noting that it was easy and quick to use in daily practice.
GP difficulties with the test were related to patient hearing loss, whereas patient difficulties were related to lack of concentration leading to misunderstanding of instructions.
IN PRACTICE:
“This study confirms the quick and easy MoCA use during routine consultations in general practice to screen for early [cognitive impairment] from the age of 50,” the authors wrote. The high prevalence of mild cognitive impairment found highlights “the importance of early screening to promote early support for patients and their entourage,” they added.
SOURCE:
The study was led by Cassandre Carton, MD, University of Lille, Lille, France, and was published online in BJGP Open.
LIMITATIONS:
Limitations included the low participation rate, a lack of in-depth exploration of GPs’ views of the MoCA, and administration of the test at a consultation selected by the GP.
DISCLOSURES:
The study did not receive any funding. The authors reported no competing interests.
 
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