Garcia-Ptacek2929 Garcia-Ptacek S, Modéer IN, Kåreholt I, Fereshtehnejad SM, Farahmand B, Religa D, Eriksdotter M.Differences in diagnostic process, treatment and social Support for Alzheimer's dementia between primary and specialist care: Resultss from the Swedish Dementia Registry. Age Ageing. 2017;46(2):314-9.
2017, Sweden |
3,891 81.1 (±6.6) 63.9% Female |
Dementia |
GP’s evaluation; ICD-10; neuroimaging; blood testing |
100% |
CDT and neuroimaging are used in most of GP’s dementia diagnosis in primary health care |
Grober3434 Grober E, Mowrey WB, Ehrlich AR, Mabie P, Hahn S, Lipton RB. Two-stage screening for early dementia in primary care. J Clin Exp Neuropsychol. 2016;38(9):1038-49.
2016, USA |
257 75.8 69.7% Female |
Dementia |
DSM-IV; interview with family members or friends |
25.7% |
Screening based on informants to reduce false- positive rates |
Noda2828 Caramelli P, Teixeira AL, Buchpiguel CA, Lee HW, Livramento JA, Fernandez LL, et al. Diagnóstico de doença de Alzheimer no Brasil. Exames complementares. Dement Neuropsychol. 2011;5(Suppl 1):11-20.
2018, Japan |
623 86.9 54.2% Female |
Dementia |
GP’s evaluation; DSM-IV |
27.4% |
DSM Score > I or > II reduces errors for dementia identification in primary health care |
Tierney3535 Tierney MC, Naglie G, Upshur R, Jaakkimainen L, Moineddin R, Charles J, Ganguli M. Factors Associated with Primary Care Physicians' Recognition of Cognitive Impairment in Their Older Patients. Alzheimer Dis Assoc Disord. 2014;28(4):320-5.
2014, Canada |
263 77.6 (±6.9) 58.55% Male |
MCI |
GP’s evaluation; MMSE < 26 |
28.5% |
MMSE would improve GP’s capacity to detect MCI in primary health care |
Wilcock2727 Wilcock J, Jain P, Griffin M, Thuné-Boyle I, Lefford F, Rapp D, Iliffe S. et al. Diagnosis and management of dementia in family practice. Aging Ment Health. 2016;20(4):362-9.
2016, England |
136 79.5 64% Female |
Dementia MCI |
Blood testing, cognitive evaluation |
100% |
An update of diagnosis records for comprehensive care is needed |
Chan3636 Chan QL, Shaik MA, Xu J, Xu X, Chen CL, Dong Y. The Combined Utility of a Brief Functional Measure and Performance-Based Screening Test for Case Finding of Cognitive Impairment in Primary Healthcare. J Am Med Dir Assoc. 2016;17(4):372.e9-11.
2016, Singapore |
309 71.7 (+-8.2) 50.2% Female |
Dementia MCI |
DSM-IV |
21.3% |
Combinations of AD8 and NINDS provided a sensitivity of 73.3% and specificity of 96.9% for dementia and MCI diagnosis, respectively |
Eichler3737 Eichler T, Thyrian JR, Hertel J, Köhler L, Wucherer D, Dreier A, et al. Rates of formal diagnosis in people screened positive for dementia in primary care: results of the DelpHi-Trial. J Alzheimers Dis. 2014;42(2): 451-8.
2014, Germany |
243 79.61 (±5.44) 61 % Female |
Dementia MCI |
DemTect < 9; medical records |
Dementia - 40% MCI-58% |
Diagnosis rates for dementia in Germany are consistent with international literature |
Eichler3838 Eichler T, Thyrian JR, Hertel J, Michalowsky B, Wucherer D, Dreier A,et al. Rates of formal diagnosis of dementia in primary care: The effect of screening. Alzheimers Dement. 2015;1(1):87-93.
2015, Germany |
243 >70 60.9% Female |
Dementia MCI |
MMSE < 23; DemTect < 9 |
Dementia - 49% |
The diagnosis rate of dementia increased 40% |
Arabi3939 Arabi Z, Rahman SASA, Hazmi H, Hamdin N. Reliability and construct validity of the Early Dementia Questionnaire (EDQ). BMC Geriatr. 2016; 16:202.
2016, Malaysia |
200 68.5 (±6.28) 52% Female |
Dementia MCI |
EDQ < 5; MMSE < 21 |
EDQ-40% MMSE-20% |
Validated questionnaire |
Shaik4040 Shaik MA, Chan QL, Xu J, Xu X, Hui RJ, Chong SS, et al. Risk Factors of Cognitive Impairment and Brief Cognitive Tests to Predict Cognitive Performance Determined by a Formal Neuropsychological Evaluation of Primary Health Care Patients. J Am Med Dir Assoc. 2016;17(4):343-7.
2015, Singapore |
309 71.8 (±8.2) 54.8% Female |
MCI |
At least one impaired cognitive domain on objective cognitive evaluation |
54.8% |
Risk factors identified were: age, female gender, hypertension, diabetes, hyperlipidemia and smoking |
Booker4141 Booker A, Jacob LE, Rapp M, Bohlken J, Kostev K. Risk factors for dementia diagnosis in German primary care practices. Int Psychogeriatr. 2016;28(7):1059-65.
2016, Germany |
11,956 80.4 61 % Female |
Dementia |
Medical Database analysis |
100% |
The risk factors identified were: diabetes, hypertension, obesity, hyperlipidemia, vascular diseases |
Rosenbloom4242 Rosenbloom M, Barclay TR, Borson S, Werner AM, Erickson LO, Crow JM, et al. Screening Positive for Cognitive Impairment: Impact on Healthcare Utilization and Provider Action in Primary and Specialty Care Practices. J Gen Intern Med. 2018;33(10):1746-51.
2018, USA |
87 77.2 (±6.2) 59.8% Female |
Dementia MCI |
Mini-Cog < 4/5 |
27.3% among screened positive on Mini-Cog |
Twice the percentage previously identified with cognitive impairment |
Lee4343 Lee JJY, Thompson CL, Shaik AM, Wan E, Chen CLH, Dong YH. Service use, advance planning and lifestyle changes following cognitive screening in primary healthcare in Singapore. Int psychogeriatr. 2017;30(1):139-45.
2017, Singapore |
140 72.15 (±8.42) 68% Male |
MCI |
MMSE; MoCA |
23.5% |
Just a small fraction of those considered high risk for developing dementia made use of health services |
Corcoles1010 Córcoles D, Malagón A, Bellsolà M, Gonzalez A, Cortizo R, Leon J,et al. Síntomas neuropsiquiátricos como factor de confusión en la detección de la demencia. Aten Primaria. 2017;50(5):267-73.
2017, Spain |
104 77.8 (±6.74) 68.3% Female |
MCI |
MMSE |
55.8% |
91.4% of cases with alteration on MMSE had no history of Cognitive Impairment |
Holsinger4444 Holsinger T, Plassman BL, Stechuchak KM, Burke JR, Coffman CJ, Williams JW Jr. Stability of Diagnoses of Cognitive Impairment, Not Dementia in a Veterans Affairs Primary Care Population. J Am Geriatr Soc. 2015;63(6):1105-11.
2015, USA |
186 74.5 (±6.5) 96.2% Male |
DementiaCIND |
Medical evaluation |
Dementia -12% CIND-31% |
20% returned to normal cognition, 67% remained impaired, and 12% developed dementia |
de Oliveira4545 de Oliveira GM, Yokomizo JE, Vinholi e Silva Ldos S, Saran LF, Bottino CM, Yassuda MS. The applicability of the cognitive abilities screening instrument-short (CASI-S) in primary care in Brazil. Int Psychogeriatr. 2016;28(1):93-9.
2016, Brazil |
102 76.81 (±7.03) 83% Female |
Dementia |
DSM-IV; medical records; MMSE; CASI-S |
46% |
Validation of CASI-S with a 93% sensitivity and 81% specificity |
Zaganas3232 Zaganas IV, Simos P, Basta M, Kapetanaki S, Panagiotakis S, Koutentaki I, et al. The Cretan Aging Cohort: Cohort Description and Burden of Dementia and Mild Cognitive Impairment. Am J Alzheimers Dis Other Demen. 2019;34(1):23-33.
2019, Greece |
3,140 73.7 (±7.8) Gender: 56.8% Female |
Dementia MCI |
DSM-IV |
Dementia-10.8% MCI-32.4% |
Dementia prevalence was 4%; in primary care 60% remain undiagnosed until detailed neuropsychiatric evaluation |
Pujades-Rodrigues4646 Pujades-Rodriguez M, Assi V, Gonzalez-Izquierdo A, Wilkinson T, Schnier C, Sudlow C, et al. The diagnosis, burden and prognosis of dementia: A record-linkage cohort study in England. PLoS One. 2018;13(6): e0199026.
2018, UK |
47,386 |
Dementia |
Medical records |
55% |
47,386 with dementia, 12,633 Alzheimer Disease, 9,540 vascular disease and 1539 with other less common causes |
Malmstron4747 Malmstrom TK, Voss VB, Cruz-Oliver DM, Cummings-Vaughn LA, Tumosa N, Grossberg GT, Morley JE. The Rapid Cognitive Screen (RCS): A Point-of-Care Screening for Dementia and Mild Cognitive Impairment. J Nutr Health Aging. 2015;19(7):741-4.
2015, USA |
533 65-92 100% Male |
Dementia MCI |
DSMIV |
Dementia -12% MCI-26% |
RCS sensitivity 89% and specificity 87% for detecting Dementia, compared to 94% and 70% for MCI |
Stein4848 Stein J, Luppa M, Kaduszkiewicz H, Eisele M, Weyerer S, Werle J et al. Is the Short Form of the Mini-Mental State Examination (MMSE) a better screening instrument for dementia in older primary care patients than the original MMSE? Results of the German study on ageing, cognition, and dementia in primary care patients (AgeCoDe). Psychol Assess. 2015;27(3):895-904.
2015, Germany |
3,327 81.14 65.3% Female |
Dementia |
GP’s and multidisciplinary group’s evaluation; DSM-IV; SIDAM |
Follow-up I - 3.2% Follow-up II - 4.62% |
MMSE was more accurate than MMSE for diagnosis |
Yang2525 Yang Y, Xiao LD, Deng L, Wang Y, Li M, Ullah S. Nurse-led cognitive screening model for older adults in primary care Geriatr Gerontol Int. 2015;15(6):721-8.
2015, China |
249 67.6 61.8% Female |
MCI |
MMSE |
Impaired cognition -12.9% MCI-41% |
Simple instruments, such as MMSE and MoCA used for screening the elderly in primary health care |
Shaik4949 Shaik MA, Khoo CH, Thiagarajah AG, Tan NC, Li-Hsian Chen C, Xu J, Dong Y. Pilot Evaluation of a Dementia Case Finding Clinical Service Using the Informant AD8 for At-Risk Older Adults in Primary Health Care: A Brief Report. J Am Med Dir Assoc. 2016;17(7):673.e5-8.
2016, Singapore |
168 80.7 56% Female |
Dementia MCI |
Nurses’ screening; AD8; Specialist’s evaluation |
Screened positive -13.7% |
98.8% of nurses considered AD8 easy to use. 78.3% of GPs considered AD8 useful |
Thyrian5050 Thyrian JR, Eichler T, Michalowsky B, Wucherer D, Reimann M, Hertel J, et al. Community-Dwelling People Screened Positive for Dementia in Primary Care: A Comprehensive, Multivariate Descriptive Analysis Using Data from the DelpHi-Study. J Alzheimers Dis. 2016;52(2):609-17.
2016, Germany |
516 80 59.5% Female |
Dementia MCI |
GP’s evaluation; ICD-10 |
MCI-90.8% Dementia-99.8% |
Older adults from primary health care are considerably underdiagnosed |
Koekkoek5151 Koekkoek PS, Janssen J, Kooistra M, van den Berg E, Kappelle LJ, Biessels GJ, Rutten GE. Cognitive Impairment in Diabetes: Rationale and Design Protocol of the Cog-ID Study. JMIR Res Protoc. 2015; 4(2):e69.
2015, Netherlands |
513 >70 |
MCI |
GP’s evaluation; DSM-IV (Dementia); Winblad et al. (MCI) |
15.2% |
This study protocol describes all the procedures for the Cog-ld study |
Chan5252 Chan QL, Xu X Shaik MA, Chong SS, Hui RJ, Chen CL, Dong Y. Clinical utility of the informant AD8 as a dementia case finding instrument in primary healthcare. J Alzheimers Dis. 2016;49(1):121-7.
2016, Singapore |
309 71.7 (±8.2) 60.5% Female |
Dementia |
DSM-IV; CDR |
36.5% |
For participant age, AD8 was better than MMSE and as good as MoCA |
Koekkoek5353 Koekkoek PS, Janssen J, Kooistra M, Biesbroek JM, Groeneveld O, van den Berg E,et al. Case-finding for cognitive impairment among people with Type 2 diabetes in primary care using the Test Your Memory and Self-Administered Gerocognitive Examination questionnaires: the Cog-ID study. Diabet Med. 2016;33(6):812-9.
2016, Netherlands |
228 76.8 60% Male |
MCI |
DSM-IV (Dementia); Winblad et al. (MCI) |
19.3% |
TYM’s negative predictive value (NPV) was 81% and SAGE’s was 85%. GP’s evaluations had a similar NPV, however, the positive predictive value was higher |
Dungen5454 Dungen P, Charante MEP, Ven PM, Marwijk HW, Horst HE, Hout HP. Case Finding of Mild Cognitive Impairment and Dementia and Subsequent Care; Results of a Cluster RCT in Primary Care. PLoS One. 2016;11(6):e0156958.
2015, Netherlands |
647 79.8 (±7.1) 39.6% Male |
Dementia MCI |
DSM-IV (Dementia); Petersen at al. (MCI) |
Dementia -14% MCI-31.5% |
The authors did not find statistical relevance in the number of diagnoses between the groups before or after intervention |
Groeneveld5555 Groeneveld ON, Berg E, Rutten GEHM, Koekkoek PS, Kappelle LJ, Biessels GJ. Applicability of diagnostic constructs for cognitive impairment in patients with type 2 diabetes mellitus. Diabetes Res Clin Pract. 2018;142:92-99.
2018, Netherlands |
120 77.0 (±4.5) 60% Male |
Dementia MCI |
DSM-IV (Dementia). MCI: not dementia, but not normal cognition; cognitive complaints; objective impairment in one or more cognitive domain; no functional impairment |
Dementia-2.5% MCI-30% |
The authors suggested that patients with type 2 diabetes should be screened for MCI and dementia. |
Campbell5656 Campbell NL, Lane KA, Gao S, Boustani MA, Unverzagt F. Anticholinergics Influence Transition from Normal Cognition to Mild Cognitive Impairment in Older Adults in Primary Care. Pharmacotherapy. 2018; 38(5):511-9.
2018, USA |
350 71.2 (±5.1) 79.1 % Female |
Dementia MCI |
Multidisciplinary group evaluation |
Dementia - 2% MCI-94.8% |
The use of anticholinergic drugs increased the likelihood of conversion from normal to MCI. On the other hand, reversion from MCI to normal cognition was not observed. |
Jessen5757 Jessen F, Wolfsgruber S, Wiese B, Bickel H, Mösch E, Kaduszkiewicz H,et al. AD dementia risk in late MCI, in early MCI, and in subjective memory impairment. Alzheimers Dement. 2014;10(1):76-83.
2014, Germany |
2,892 79.7 (±3.58) 64.8% Female |
Dementia MCI SMI |
CERAD’s verbal memory task (SMI, eMCI, and IMCI); DSM-IV, SIDAM (Dementia) |
Ml - 36.6% eMCI - 8.6% MCI-12.3% DA-7.4% |
The highest risk for developing dementia was in the late MCI group. In SMI and early MCI groups, those who had concerns about their memory impairment had a similar risk for developing dementia. |
Wray5858 Wray LO, Wade M, Beehler GP, Hershey LA, Vair CL. A program to improve detection of undiagnosed dementia in primary care and its association with healthcare utilization. Am J Geriatr Psychiatry. 2014;22(11): 1282-91.
2014, USA |
5,333 80.7 97% Male |
Dementia |
Medical records |
Not mentioned |
B0MC+ patients were 5.12 times more likely to receive a dementia diagnosis, when comparing to BOMC- group. |
Alonso5959 Alonso TV, Espí MM, Reina JMM, Castrillejo D. Prevalencia de deterioro cognitivo en Espãna. Estudio Gómez de Caso en redes centinelas sanitarias. Neurologia. 2016;33(8):491-8.
2016, Spain |
4,360>65 |
MCI |
Mini-cog screening test, MMSE and Alzheimer’s Questionnaire |
18.5% |
Cognitive impairment is a common reason for appointments in primary health care. |
Brodaty6060 Brodaty H, Connors MH, Loy C, Teixeira-Pinto A, Stocks N, Gunn J,et al. Screening for dementia in primary health care: a comparison of the GPCOG and the MMSE. Dement Geriatr Cogn Disord. 2016;42: 323-30.
2016, Australia |
1,717 81.05 (±4.12) |
Dementia |
Medical records, MMSE |
7.3% |
GPCOG’s sensitivity was 79% and specificity 92%. |