E-SPACE · European Standardised Process Approach to Cognitive Evaluation in older people

European Standardised Process Approach to Cognitive Evaluation in older people

Background: Cognitive evaluation is important for early and accurate dementia diagnosis. However, currently available cognitive tests, particularly brief screening tests, are not always reliable in detecting the earliest stages of cognitive decline. This project aimed to improve current measures, using a process-based approach to cognitive assessment, as cognitive testing will be incomplete if it relies on summary scores alone and does not take account of other aspects of test performance. Typically, cognitive evaluation pays attention only to “what” one does (i.e. test scores). Above a certain score or cut-point (e.g. ≥24/30), the person may be considered “healthy” and below that cut-point (≤23) there could be suspicion of cognitive deterioration. However, people with high education levels may perform above the cutoff and look “healthy” when they may not be and people with low education levels may perform poorly despite being cognitively healthy. Misclassification can result in failure to detect deterioration or in classifying someone as impaired when they are not. Both scenarios highlight the need to improve tests to ensure early and proper diagnosis. Importance for society: The benefits of early and accurate diagnosis of Mild Cognitive Impairment and/or dementia include the fact that the person may still be able to participate actively in care planning and in decision-making about important issues like drug treatments, legal and financial affair management and service options. Early and correct diagnosis can also enable the person and family members to adjust and adapt. This may improve quality of life and reduce stress. Furthermore, at a societal level, timely diagnosis can reduce healthcare costs by delaying nursing home admission. Project objectives: The main goal of this project was to review existing screening tests and, where possible, to improve those measures to provide clinicians with better tools for early and accurate diagnosis. Conclusions of the Action: We identified and developed two test batteries that allow clinicians perform a brief cognitive assessment. Tests are administered in the usual manner, but the clinician now pays attention to the person’s answers and registers them verbatim so that answers and errors can be examined in detail.

Data: CORDIS, © European Union