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Service use, advance planning and lifestyle changes following cognitive screening in primary healthcare in Singapore

Published online by Cambridge University Press:  20 September 2017

Jamie Jia Yan Lee
Affiliation:
School of Psychology, James Cook University, Singapore
Claire L. Thompson
Affiliation:
School of Psychology, The Cairnmillar Institute, Melbourne, Australia College of Healthcare Sciences, James Cook University, Townsville, Australia
Muhammad Amin Shaik
Affiliation:
Department of Pharmacology, Memory Aging and Cognition Centre, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
Esther Wan
Affiliation:
Department of Pharmacology, National University of Singapore, Singapore
Christopher Li-Hsian Chen
Affiliation:
Department of Pharmacology, Memory Aging and Cognition Centre, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
Yan Hong Dong*
Affiliation:
Department of Pharmacology, National University of Singapore, Singapore Centre for Healthy Brain Ageing (CHeBA) and Dementia Collaborative Research Centre – Assessment and Better Care, School of Psychiatry, UNSW Medicine, The University of New South Wales, Sydney, Australia
*
Correspondence should be addressed to: Dr Yan Hong Dong, Department of Pharmacology, National University of Singapore, BLK MD3 Level 4 #04-01, 16 Medical Drive, 117600, Singapore. Phone: +65 6601 3288. Email: yanhong_dong@nuhs.edu.sg.

Abstract

Background:

Despite recent interest in community-based screening programs to detect undiagnosed cognitive disorder, little is known about whether screening leads to further diagnostic evaluation, or the effects of such programs in terms of actual changes in patient or caregiver behavior. This study followed up informants of older adults (i.e. caregivers of patients who completed informant-based screening regarding the patient) following participation in a study screening for undiagnosed memory problems, to explore uptake of further diagnostic evaluation or treatment, advance planning or preparations, lifestyle changes, medication adherence, and use of support services.

Methods:

A total of 140 informants of older adult patients were surveyed four to fifteen months following participation in a cognitive screening study. The informants were interviewed with a study-specific survey about cognitive assessment, advance planning, lifestyle changes, and use of support services and general medication adherence.

Results:

A minority of patients and informants had engaged in advance planning or made relevant lifestyle changes following cognitive screening. Those assessed as being at higher risk of memory problems were more likely to have attended a full diagnostic evaluation, engaged in support services and experienced medication adherence difficulties.

Conclusion:

Only a small proportion of patients participating in cognitive screening subsequently engaged in diagnostic evaluation, advance planning, or lifestyle changes. However, those with higher risk of cognitive impairment were generally more likely to take some action following cognitive screening. Those at higher risk were also more vulnerable due to greater difficulties with medication adherence.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2017 

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