Early Screening of Senile Dementia in Community Based Care: a Systematic Review

Abstract

Senile dementia rate has been increasing. Early screening for senile dementia in community setting is very crucial. Previous studies reported that the evidence regarding effective screening tools and proce-dures were very limited. This systematic review aimed to find the evidence of the screening procedure and screening tools for early onset of dementia in elderly in community context. The searching protocol was based on the Joanna Brigg Institute (JBI)’s concept. PICo framework was used to find the evidence. Researches published in English, via Medline/Pubmed, CINAHL, ThailLIS database during 2005-2015 were included in this review. CASP was used for critical appraisal process. All studies were appraised and extracted by the research team. The result of this review found 318 studies, but only 16 quality studies were recruited. Ten screening tools were identified. Montreal Cognitive Assessment (MoCA) tool was mainly used and was translated into various languages. Memory Impairment Screen (MIS) and Commu-nity Screening Instrument for Dementia (CSI-D) were also found respectively. Most studies used Mini-Mental State Examination (MMSE) as a common accuracy tool to compare the effectiveness of other potential tools. The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) was also used to confirm the diagnosis of dementia onset. Majority of studies reported that results from screen-ing tools in their studies were similar to MMSE and some reported better screening results in early detec-tion. Result showed that the sensitivity of screening tools included in this review were 0.80-0.90 whereas specificity were ranged from 0.75-0.90. The screening procedure found that most studies recruited par-ticipants from database in university’s elderly clinic. The screening process was normally implemented by trained staff or multi-disciplinary health professional staff. Biophysical test was used in some studies to confirm or classify type of dementia.