title: Point-of-care screening to identify cognitive impairment in older adults.
abstract: OBJECTIVE
  To explore associations between results of a rapid screening tool for cognitive impairment and individual patient characteristics in a sample of patients receiving outpatient anticoagulation therapy who were not previously diagnosed with a dementia.
  
  
  METHODS
  Descriptive, nonexperimental, cross-sectional study.
  
  
  METHODS
  Pharmacist-managed anticoagulation clinic in Spokane, WA, from June 2006 to March 2007.
  
  
  METHODS
  300 community-dwelling patients aged 60 years or older who had at least 6 months of outpatient anticoagulation therapy services.
  
  
  METHODS
  Following informed consent, demographic, medical history, medication history, anticoagulation therapy, and cognitive screening data were recorded from participant medical records, and a participant interview was performed using a standardized questionnaire and data collection form.
  
  
  METHODS
  Cognitive screening status (suggests cognitive impairment versus suggests dementia less likely) was used as an independent variable by which to compare patient demographics, medical history, medication history, and percent of out-of-range International Normalized Ratio (INR) visits.
  
  
  RESULTS
  55 of 300 participants (18.3%) with no previous diagnosis of a cognitive impairment were classified as "suggests cognitive impairment" based on the screening test. Presence or absence of cognitive impairment differed in those needing assistance with taking medications but was not associated with other sample characteristics, including percentage of visits with out-of-range INR value, gender, in-home care needs, age, and number of medical conditions.
  
  
  CONCLUSIONS
  Screening at a convenient health care access point may lead to increased identification of community-dwelling elderly patients with unrecognized and undiagnosed cognitive impairment. Pharmacists are particularly well suited to conduct this screening because of the extended and frequent contact they have with patients in settings such as anticoagulation therapy clinics.
authors: College of Pharmacy, Washington State University, P.O. Box 646510, Pullman, WA 99164-6510, USA. tsonnett@wsu.edu
authors: Travis E
authors: TE
authors: Sonnett
authors: Stephen M
authors: SM
authors: Setter
authors: Douglas L
authors: DL
authors: Weeks
authors: Soo
authors: S
authors: Borson
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D003072:Cognition Disorders / Q000175:diagnosis*; D003430:Cross-Sectional Studies; D003704:Dementia / Q000175:diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D010595:Pharmacists; D019095:Point-of-Care Systems; D012307:Risk Factors
chemical_list: D000925:Anticoagulants