Dados do Trabalho

Título

The Use of the Cognitive Change Questionnaire by Community health workers as dementia screening method.

Resumo

Introduction: Brazil has a public health system that uses family medicine as main strategy and the Community Health Workers play a very important role. The Cognitive Change Questionnaire (CCQ) was a tool developed in Brazil to evaluate cognitive changes in a simple way to allow a triage for dementia patients. Objective: To evaluate the applicability of the CCQ by Community Health Workers (CHW) as a screening tool for dementia in a community. Method: This study was carried out in Pindoretma-CE, a 20.000 habitants town in the proximities of Fortaleza. Community health workers were trained on basic dementia principles and how to apply the CCQ. Patients assisted by 3 health care units were invited to participate in the study. The CHW was applied by the CCQ to people aged 60 or over individuals during routine home visits. Questionnaires were evaluated afterwards by a neurologist with expertise in cognitive neurology. Patients were than recruited and accessed by the same neurologist using a structured medical interview, neurological and cognitive examination, and functionality tests. The batteries used were: mini mental state exam, Brief cognitive battery, Dementia Rating Scale, Pfeffer's Functional Activities Questionnaire, Geriatric Depression Scale 15-item version. After evaluation, data were discussed with at least two neurologists, to define whether or not the case would be classified as dementia syndrome. Result: A total of 213 patients were evaluated; 42 patients were identified as having dementia syndrome. Statistical analysis comparing the score obtained in the test with the probability of the patient having or not having dementia is still in progress. Conclusion: Application of the QCC by CWH is a possible screening tool for dementia in small communities. Additional data regarding accuracy are needed before this strategy can be used in clinical practice.