• Screen routinely! Cognitive screening can be performed during routine clinical assessments. For optimal health outcomes, screening should be done:
  • Annually if there are no obvious signs of cognitive impairment.
    • For Medicare recipients that receive care in Primary Care settings, utilize Medicare Annual Wellness visits to conduct cognitive screening
  • More frequently when signs of cognitive impairment are observed on interview or reported by patient or caregivers
• Routine screening may identify HF patients vulnerable to developing cognitive impairment, enabling disease management strategies to be initiated and tailored to individual patient needs.

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Screening can be stressful for patients. Be sure to establish rapport and introduce the screen as a routine assessment, for example: “The same way as we always check the vital signs, we now routinely check the health of the brain by asking all patients few questions”.

Centers for Medicare and Medicaid recommends using the Mini-CogTM or Ascertain Dementia 8-item Informant Questionnaire (AD 8) Screening Interview. Both questionnaires are validated screening tools for cognitive impairment, and may be completed within a few minutes during a routine clinical assessment.

Because depression may either cover symptoms of underlying cognitive impairment, or coexist with a cognitive impairment diagnosis, it is recommended to differentiate depressive symptoms from cognitive impairment using the Patient Health Questionnaire-2 (PHQ-2).

Cognitive screen results alone are not diagnostic. A dementia diagnosis also requires a complete history, examination, and laboratory tests.

Cognitive screen results alone are not diagnostic. A dementia diagnosis also requires a complete history, examination, and laboratory tests.