The 5-Cog Paradigm Improves Diagnosis, Management of Dementia

TUESDAY, June 11, 2024 (HealthDay News) -- For older adults with cognitive concerns, the 5-Cog paradigm, a culturally adept, cognitive detection tool, paired with a clinical decision support, can improve diagnosis and management of dementia, according to a study published online June 4 in Nature Medicine.

Joe Verghese, M.B.B.S., from the Albert Einstein College of Medicine in New York City, and colleagues conducted a randomized controlled trial in primary care patients experiencing health disparities to examine whether the 5-Cog paradigm can reduce barriers to dementia diagnosis and care. Older adults with cognitive concerns were allocated to the 5-Cog paradigm or control in a 1:1 ratio (599 and 602, respectively).

The researchers found that compared with the control, the 5-Cog paradigm demonstrated threefold odds of improvement in dementia care actions, defined as any of the following end points within 90 days: new mild cognitive impairment syndrome or dementia diagnoses as well as investigations, medications, or specialist referrals ordered for cognitive indications (odds ratio, 3.43). There were no reports of serious intervention-related adverse events.

"The 5-Cog paradigm helped to improve dementia care actions related to diagnosis, investigations, and treatments that account for many implementation barriers and racial/ethnic differences in primary care patients presenting with cognitive concerns," the authors write. "This trial provides the evidence base to develop cognitive detection guidelines to promote practice change in primary care."

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