Medicine and Health

Non-literacy biased, culturally fair cognitive detection tool in primary care patients with cognitive concerns: a randomized controlled trial

J. Verghese, R. Chalmer, et al.

Discover how the 5-Cog paradigm significantly enhanced dementia care actions in primary care settings, revealing threefold odds of improvement compared to control. This breakthrough research, conducted by Joe Verghese and colleagues at Albert Einstein College of Medicine, sheds light on the potential for better management of dementia diagnosis in underserved populations.

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Abstract

Dementia is frequently undiagnosed and untreated in primary care. This randomized controlled trial (RCT) evaluated the 5-Cog paradigm, a brief, culturally appropriate cognitive detection tool paired with clinical decision support, in primary care patients experiencing health disparities. Older adults with cognitive concerns were randomly assigned to the 5-Cog paradigm or a control group. The primary outcome was improved dementia care actions within 90 days. The 5-Cog paradigm demonstrated threefold odds of improvement in dementia care actions compared to the control (odds ratio 3.43, 95% confidence interval 2.32-5.07). No serious adverse events were reported. The 5-Cog paradigm improved dementia diagnosis and management and provides evidence to support practice changes for better dementia care in primary care.

Publisher

Nature Medicine

Published On

Jun 04, 2024

Authors

Joe Verghese, Rachel Chalmer, Marnina Stimmel, Erica Weiss, Jessica Zwerling, Rubina Malik, David Rasekh, Asif Ansari, Roderick A. Corriveau, Amy R. Ehrlich, Cuiling Wang, Emmeline Ayers

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