Focused Cognitive Testing in Inpatients

Luzerner Kantonsspital150 enrolled

Overview

Neurocognitive Disorder (NCD) affects over 116'000 people in Switzerland and is frequently unrecognized and underdiagnosed. Because missed and delayed diagnosis are associated with an increased burden of disease health Service Research has prompted a discussion about diagnostic guidelines and screening programs. Some argue that screening for NCD in primary care is the optimal strategy to increase recognition rates; others consider test protocols implemented into hospital admission assessments as more justified. There is no distinct recommendation due to a lack of empirical data on the benefits and harms of cognitive testing yet. This trial strives to fill this gap and provide information about the benefits, harms and the economic case of routine cognitive testing for neurocognitive disorder in high risk elective inpatients, in Switzerland. The investigators hypothesize that, cognitive tested patients, compared with patients not cognitive tested, will have higher health-related quality of life at 12months; and lower medical health care costs at 18months.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

SUPPORTIVE_CARE

Masking

SINGLE

Enrollment

150

Conditions

Neurocognitive Disorders

Interventions

Subjects of the Intervention-Group will undergo a brief cognitive assessment, using the BRAINCHECK, during hospital admission assessments. Subjects with positive results will then be referred to a Memory Clinic undergoing subsequent interdisciplinary comprehensive diagnostic examinations. Patients with established diagnosis will be invited to counselling services of the Alzheimer Association (providing social counselling).

Eligibility

Sex: ALLMin age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Elective inpatients, living in the canton of lucerne, high risk of developing a major neurocognitive disorder, living at home Exclusion Criteria: * Known mental disorder according to ICD-10, chapter V, excluding F32 \& F33, patients with terminal illness, patients of intensive care unit or oncology patients, no adequate vision or hearing, no ability to speak, write or to understand German, no Informant, antidementia medication

Outcomes

Primary Outcomes

Health related quality of life (HRQoL)

Patient and Caregiver, using EuroQol 5D-5L

Time frame: every month during 18months

Health Service Resource Utilization / Costs

Patient and Caregiver, using Resource Utilization in Dementia (RUD)

Time frame: every month during 18months

Secondary Outcomes

prevalence of neurocognitive disorder

at Hospital admission

Time frame: baseline/6months

prevalence of risk factors associated with developing major neurocognitive disorder within 6 years

at Hospital Admission, using Brief Dementia Screening Indicator (BDSI)