Focused Cognitive Testing in Inpatients

Study Overview
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Brief Summary
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Neurocognitive Disorder (NCD) affects over 116'000 people in Switzerland and is frequently unrecognized and underdiagnosed. Because missed and delayed diagnosis are associated with an increased burden of disease health Service Research has prompted a discussion about diagnostic guidelines and screening programs. Some argue that screening for NCD in primary care is the optimal strategy to increase recognition rates; others consider test protocols implemented into hospital admission assessments as more justified. There is no distinct recommendation due to a lack of empirical data on the benefits and harms of cognitive testing yet. This trial strives to fill this gap and provide information about the benefits, harms and the economic case of routine cognitive testing for neurocognitive disorder in high risk elective inpatients, in Switzerland. The investigators hypothesize that, cognitive tested patients, compared with patients not cognitive tested, will have higher health-related quality of life at 12months; and lower medical health care costs at 18months.

Official Title
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Analysis of Clinical- and Cost-effectiveness of Focused Cognitive Testing in Elective Inpatients

Conditions
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Neurocognitive Disorders

Intervention / Treatment
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* Other: BRAINCHECK


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Elective inpatients, living in the canton of lucerne, high risk of developing a major neurocognitive disorder, living at home Exclusion Criteria: Known mental disorder according to ICD-10, chapter V, excluding F32 & F33, patients with terminal illness, patients of intensive care unit or oncology patients, no adequate vision or hearing, no ability to speak, write or to understand German, no Informant, antidementia medication

Ages Eligible for Study
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Minimum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention-Group<br> | Other: BRAINCHECK<br>* Subjects of the Intervention-Group will undergo a brief cognitive assessment, using the BRAINCHECK, during hospital admission assessments. Subjects with positive results will then be referred to a Memory Clinic undergoing subsequent interdisciplinary comprehensive diagnostic examinations. Patients with established diagnosis will be invited to counselling services of the Alzheimer Association (providing social counselling).<br>|
| No Intervention: Control-Group<br> | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Health related quality of life (HRQoL) | Patient and Caregiver, using EuroQol 5D-5L | every month during 18months | 
| Health Service Resource Utilization / Costs | Patient and Caregiver, using Resource Utilization in Dementia (RUD) | every month during 18months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| prevalence of neurocognitive disorder | at Hospital admission | baseline/6months | 
| prevalence of risk factors associated with developing major neurocognitive disorder within 6 years | at Hospital Admission, using Brief Dementia Screening Indicator (BDSI) | baseline/6months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Dementia, Dementia screening, General Hospital, Inpatients