Gaps in Cognitive Impairment Screening in Primary Health Care
Keywords:
cognitive dysfunction; risk factors; mental status and dementia test; neuropsychological testAbstract
Introduction: Primary care physicians are the fundamental link in detecting neurocognitive disorders; however, screening is poorly performed.
Objective: To identify gaps in cognitive impairment screening performed by primary care physicians.
Methods: A cross-sectional, analytical, observational study was conducted using a virtual questionnaire, administered to 66 physicians at the Teaching Polyclinic Manuel Fajardo Rivero in the municipality and province of Las Tunas, Cuba, from April 1 to June 30, 2025. Absolute and relative frequencies were calculated, modes and means were analyzed, and associations were evaluated using Fisher's test or Pearson's chi-square test.
Results: 100 % interacted with patients who presented cognitive decline and risk factors. Specialists reported having performed cognitive impairment screening and received training with higher percentage frequencies. Mini-Mental Statement Examination (MMSE) was the most used by them, while Montreal Cognitive Assessment (MoCA) and Addenbrroke’s Cognitive Examination-Revised (ACE-R) by residents. These reported mastery of the diagnostic criteria at a higher percentage frequency. Family physicians reported having performed screening at a lower percentage frequency and greater mastery of the diagnostic criteria, although at a lower percentage frequency. A significant association was found between screening, training, and applied neurocognitive tests (MMSE and MoCA), with the specialty.
Conclusions: Training, mastery of diagnostic criteria, and screening for cognitive impairment by primary care physicians are insufficient. Extensive training is needed to expand screening and eliminate its gaps.
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