Effective cognitive screening tools for Alzheimer’s disease in the primary care setting: the role of the visual paired associative learning task

Ravona‐Springer, Ramit

doi:10.1017/s1041610221000338

Cited by 1 publication

(1 citation statement)

References 30 publications

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“…This suggests that health workers in primary care settings require continuous training on cognitive impairment screening through continuous professional developments, and continuous medical education ( 19 ). Furthermore, brief assessment tools need to be locally developed, tested and standardized to be integrated into daily clinical practice in order to simplify the screening process ( 24 ). Primary healthcare providers should be encouraged to adhere to the Uganda Clinical Guidelines handbook as a guide available for quick identification of dementia or cognitive impairment symptoms ( 19 ).…”

Section: Discussionmentioning

confidence: 99%

Barriers and facilitators to cognitive impairment screening among older adults with diabetes mellitus and hypertension by primary healthcare providers in rural Uganda

Muwanguzi

Obua

Maling

et al. 2023

Front. Health Serv.

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BackgroundThe burden of non-communicable diseases and cognitive impairment exhibit a linear rise in sub-Saharan Africa due to the increase in life expectancy. Non-communicable diseases like diabetes mellitus and hypertension increase the risk for cognitive impairment. To improve our understanding of the underpinnings of the cognitive impairment screening, this study explored the barriers and facilitators of routine cognitive impairment screening in a primary healthcare setting guided by the Capacity, Opportunity, Motivation Behavioral change (COM-B) model.MethodsThis was a descriptive qualitative study with primary healthcare providers who provide care to older adults with diabetes mellitus and hypertension at three primary healthcare centers in Mbarara district southwestern Uganda. In-depth interviews were conducted using a semi structured interview guide. Interviews were audio-recorded, transcribed verbatim, and analyzed using the framework approach along the COM-B components. Each COM-B component factors were categorized as barriers and facilitators.ResultsWe conducted 20 in-depth interviews with clinical officers, enrolled nurses, and a psychiatric nurse. The questions were guided by the Capacity, Opportunity and Motivation Behavioral change (COM-B) framework to identify barriers and facilitators to cognitive impairment screening. The factors that negatively affected the screening were considered as barriers, while the positive as facilitators. Capacity related barriers to cognitive impairment screening included chronic understaffing, primary healthcare provider non-involvement, lack of training/skills, lack of knowledge and awareness in screening, absence of caretakers, lack of patient awareness of cognitive problems; while facilitators were staff recruitment, primary healthcare provider involvement, and specialized training. Opportunity related barriers to screening included patient overload, infrastructure shortage, and time constraints. Motivation related barriers included lack of screening guidance and policy, while the facilitators were availability of mentorship programs for primary healthcare providers.ConclusionsIntegrating cognitive impairment screening in primary health care requires engagement of relevant stakeholders with the focus on addressing implementation challenges through capacity development. Timely cognitive impairment screening at the first point of care initiates a cascade of interventions for timely enrollment into care, thus arresting the progress of cognitive impairment that leads to dementia.

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Section: Discussionmentioning

confidence: 99%