Pilot evaluation of the informant AD8 as a case-finding instrument for cognitive impairment in general practitioner clinics of Singapore: A brief report

Background Case-finding services using a composite total risk score (TRS) and the informant AD8 have been previously recommended to detect cognitive impairment (CI) in government subsidized primary health care centers of Singapore (ie, polyclinics). Objective We compared the feasibility of implementing the services recommended for government-subsidized primary health care in private, primary health care service providers such as general practitioner (GP) clinics. Method 123 patients ≥60 years of age were recruited from 2 GP clinics within Singapore. Trained research personnel administered the AD8 to informants. Patients of the present study were compared against a random sample of 123 patients selected from polyclinics. Results Significantly higher positive screening rates (AD8 ≥3) were found among patients in polyclinics than GP clinics (P < .001). Patients attending polyclinics reported more comorbid medical issues such as subjective cognitive complaint (P < .001) and heart disease (P < .001). The TRS of patients attending polyclinics was significantly higher than those attending GP clinics (P < .001), indicating a higher proportion of patients at risk of CI in polyclinics. Therefore, patients attending polyclinics were found to have higher AD8 scores compared with patients in GP clinics (P < .001). Conclusion Compared with GP clinics, polyclinics may be more suited to provide case-finding services for the detection of CI in primary health care