5-Cog Battery for Detecting Cognitive Impairment and Dementia (5-Cog)
Dementia, Cognitive Impairment, Mild Cognitive Impairment
About this trial
This is an interventional screening trial for Dementia focused on measuring Cognitive screening, Primary care, Dementia, Cognitive Impairment, Mild Cognitive Impairment
Eligibility Criteria
Inclusion Criteria:
- Age 65 and older.
- Presence of cognitive or memory concerns expressed by patient, caregiver, health care provider or other source who knows the patient.
- Registered as patient at Montefiore Medical Center and have a primary care doctor appointment that day.
- Able to hear and see well enough to complete intervention or control assessments.
- English or Spanish speaking.
Exclusion Criteria:
Prior diagnosis of dementia or MCI as ascertained by ICD-10 codes or the documentation of prescription for anti-dementia medications in EMR. Patients with a diagnosis containing any of the following terms will be excluded:
- "Dementia"
- "Mild Cognitive Impairment"
- "Alzheimer's Disease"
- "Creutzfeldt-Jakob Disease"
- "Major Neurocognitive Disorder"
- "Minor Neurocognitive Disorder"
Patients with any of the following medications documented in their EMR will be excluded (generic = brand):
- Donepezil = Aricept
- Memantine = Namenda
- Rivastigmine = Exelon
- Galantamine = Razadyne
- Donepezil and Memantine = Namzaric
- Adults who are permanent residents of a nursing facility.
- Patients who do not speak English or Spanish.
- Patients who are not seeing a primary care physician at the clinic that day.
- Patients who are blind or deaf or cannot hear loud voice even with hearing aids.
Sites / Locations
- Albert Einstein College of Medicine
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
5-Cog
Health Literacy & Grip Assessment
The 5-Cog coupled with a decision tree is a simple, 5-minute procedure that will identify older persons with cognitive impairment in primary care settings, and flag them for further evaluation. The 5-Cog includes the Picture Memory Impairment Screen (PMIS), Motoric Cognitive Risk syndrome (MCR), and the Symbol Match test. The 5-Cog will be given after randomization and before the patients sees the physician. The 5-Cog will sort patients with 'cognitive impairment' from those with 'no cognitive impairment'. After completing the 5-Cog, the non-physician tester will send a message through the Electronic medical record (EMR) system to provide the physician with the 5-Cog results and guide the them through the follow-up based on the results.
The 5 minute assessment includes the Short Assessment of Health Literacy (SAHL) and a grip assessment measured using a handgrip dynamometer. After completing the SAHL and grip assessment, the non-physician tester will send a message through the EMR to provide the physician with the results from the assessments and guide the them through the follow-up based on the results.