![]() For the GP, this includes full attention to cardiovascular risk factors and advice about diet, physical activity and social and cognitive engagement. If a diagnosis is made, whether of dementia or a milder degree of cognitive impairment that may progress to dementia, there is mounting evidence for secondary prevention that can slow the progression of the condition. Once cognitive impairment is identified, the GP should also tailor management of comorbidities, putting in more structure and reminders, perhaps with the assistance of a care plan and the practice nurse. Family and other carers should be educated about the implications of the diagnosis, as this aids understanding of prognosis and facilitates access to social care services. However, as with other terminal illnesses, it may be helpful for a person to know what is happening: while they still have capacity, they can complete their advance care planning (will, appointment of health and financial spokespeople, advance care directive), fulfil ‘bucket list’ plans and perhaps access anti-dementia medications and implement diet and exercise interventions to slow progression. 3 Indeed, the diagnosis is a grim one of a terminal illness with progressive deterioration. Patients themselves have a range of views about this, and a large minority are not keen to be diagnosed with dementia. *The presence of one or more of these factors places a person at moderate risk of dementia and warrants case finding for cognitive impairmentīefore proceeding with investigation of cognitive impairment, it is worth asking whether the potential benefits of this assessment are likely to outweigh possible harms. Identifying as an Aboriginal or Torres Strait Islander person Factors associated with moderate risk of dementia* 4,11Įlevated cardiovascular risk (eg heart disease, stroke, hypertension, obesity, diabetes, elevated homocysteine, elevated cholesterol, smoking, sedentary lifestyle) ![]() This article will discuss the steps for GPs to assess cognitive impairment in the case-finding group (ie those at moderate risk of dementia ) in order to minimise visits and provide the specialist with a rationale for their decision‑making.īox 1. However, some GPs may still prefer to refer cases for confirmation of the diagnosis. Some patients may be interested in referral to a centre conducting clinical trials of potential new treatments. However, as the numbers of people developing dementia increase, specialist referral is becoming less feasible economically and logistically, and so is now recommended only for those who wish to take anti-dementia medication, for complex cases where the diagnosis is unclear, or for those requesting to see another specialist. What, then, is the role of the general practitioner (GP)? More than a decade ago, many GPs expected to refer their few incident cases of dementia to other specialists for investigation and diagnosis. 1 Australia is no exception, with population numbers living with dementia expected to exceed one million by 2056. This number is expected to increase to 131 million by 2050 because of the increasing longevity of the world population. Over 46 million people live with dementia worldwide. We provide correction grids to adjust raw scores and equivalent scores with cut-off value to allow comparison between MoCA performance and others neuropsychological test scores that can be administered on the same subject.Dementia is a condition with variable manifestations, affecting cognition, behaviour and the person’s ability to perform activities of daily living. Linear regression analysis was performed to evaluate the potential effect of age, education and sex on the MoCA total performance score. ![]() None of the participants had a history of psychiatric, neurological, cerebrovascular disorders or brain injury or took drugs affecting cognition. The global normal cognition was established in accordance with the Mini-Mental State Examination score and with the Prose Memory Test score (Spinnler and Tognoni, Ital J Neurol Sci 6:25-27, 1987). In this study we report normative data on the MoCA-Italian version, collected on a sample of 225 Italian healthy subjects ranged in age between 60 and 80 years, and in formal education from 5 to 23 years. to detect mild cognitive impairment, a high-risk condition for Alzheimer's disease and other forms of dementia. ![]() The Montreal Cognitive Assessment (MoCA) is a brief cognitive screening instrument developed by Nasreddine et al.
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