Development of a Cognitive Screening Process for Older Adults in Community
Keywords:
The Abbreviated Mental Test, Cognitive Screening Administration, Older Adults in CommunityAbstract
This research and development study aimed to 1) describe the situation of a cognitive screening, 2) develop a process for administrative cognitive screening, 3 validate an Abbreviated Mental Test (AMT), and 4) evaluate the outcomes of administrative cognitive screening in the community. Participants were 446 older adults recruited by cluster sampling from 200,481 adults aged more than 60 years. Measurement included a cognitive screening administration project, an Abbreviated Mental Test (AMT), a Mini-Mental State Examination, a Self-report checklist, as well as an aging survey database for Udonthani. Data were analyzed using descriptive statistics and content analysis. The study found that 1) The initial cognitive screening in the annual health examination, performed by volunteer health workers with the AMT test, found cognitive impairment in only 1.1% of the sample and 84.2% of nurses in district health promotion hospital did not have experience with cognitive screening. 2) A process for administrative cognitive screening was developed by educating the nurses and other health personnel, practicing cognitive screening and how to enter data to database and periodic evaluation. 3) The validation of the AMT test revealed that some items were contextual and cultural limitations and not appropriate for older adults in the community. 4) After training, AMT was examined to the same older adult sample, cognitive impairment was found almost 24 times greater. Most nurses and health personnel were able to administer cognitive screening according to the guidelines, except having an appropriate area to do the test. The sample population suffering from cognitive impairment, as defined by MMSE, was 12.3%. Most older adults felt more comfortable and confident having the screening test administered by trained health personnel than volunteer health workers who they felt were not as professional in giving this test. Therefore, we suggest that the Thai AMT should be modified so an appropriate screening tool would produce a scale that measures more adequately. Cognitive screening should be administered by trained nurses.
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