Collaborative AAPA, PA Foundation, Cleveland Clinic Alzheimer’s Early Detection Project Moves into Pilot Phase
Providers at Five Rural Sites are Now Using Innovative Cognitive Assessment Toolkit with Patients
June 27, 2023
By Sarah Blugis
Last year, the American Academy of PAs (AAPA), the PA Foundation, and Cleveland Clinic were awarded a grant from the Davos Alzheimer’s Collaborative (DAC), the organization leading a global response to Alzheimer’s disease. Together, these organizations have worked to develop a pilot cognitive assessment toolkit for medical providers to increase rates of cognitive screenings.
As the aging population grows and the cases of dementia increase, it is more important than ever to ensure that front-line providers like PAs are equipped with the knowledge and resources they need to conduct cognitive assessments and screenings. Early detection is key to managing Alzheimer’s disease, a progressive brain disorder and the most common type of dementia. Cognitive decline is not inevitable, and therapeutic interventions for those in mid-life with early Alzheimer’s disease are now viewed as critical to unlocking a potential 40% reduction in late-life Alzheimer’s.
“I wanted to be involved in [this project] to learn more about screening patients in the primary care setting and have access to a toolkit that would guide me in that process,” said Adam Thornton, PA-C, the provider lead at the rural practice site in Tennessee. “Alzheimer’s disease diagnoses are not typically made at my level, but I am at the tip of the spear when it comes to getting my patients that need further evaluation where they need to be.”
The toolkit addresses key areas for providers, including cognitive screening tools and protocols; administering screenings; and training and educational resources for interpreting results and facilitating conversations with patients. After taking several weeks to review and familiarize themselves with the toolkit, providers at Cleveland Clinic and at five rural practice sites – located in Alabama, Idaho, Maryland, Oregon, and Tennessee – are now utilizing these tools and resources in their daily practice over a 12-week period.
“Recognizing cognitive decline involves not only the interview of the patient and family, but also knowing how to use the available screening tools and interpreting the results to identify the issues,” said James R. Kilgore, DMSc, PhD, PA-C, DFAAPA, the provider lead at the rural practice site in Alabama. “This is a very important opportunity for my patients and myself to be a part of this work to identify cognitive decline and make appropriate recommendations.”
The overall goal of the project is to increase the rates of cognitive screenings for eligible patients by bolstering providers’ levels of comfort and knowledge around conducting those screenings, having conversations with their patients, and referring patients for further assessment as needed. Throughout the 12-week pilot period, providers at each site will collect clinical data about patient outcomes related to use of the cognitive assessment toolkit. For example, for each patient over 65, providers will record whether they received a cognitive screening, why, what the result of that screening was, what tool was used, and what provider administered that tool.
“We have very few neurologists in southern Maryland, so primary care providers care for many conditions that more urban providers would refer out to specialists,” said Jen Mohler, PA-C, the provider lead at the rural practice site in Maryland. “With this toolkit, we can be more confident in discussing the screening results and next steps of diagnosis, treatment, and when necessary, referral.”
At the conclusion of the 12-week pilot and data collection period, the toolkit will be refined and revised based on the data collected, as well as feedback from provider leads and their teams. Once the toolkit has been finalized, it will be publicly available on AAPA.org, with a projected launch date of November 1, 2023.
Through this grant, Cleveland Clinic, AAPA, and the PA Foundation join a network of 12 grant projects, all part of the DAC Healthcare System Preparedness project, which aim to advance how healthcare systems worldwide detect, diagnose, treat, and care for people with or at risk for Alzheimer’s.
Cleveland Clinic, AAPA, and the PA Foundation will have an opportunity to extend the project’s impact by sharing best practices through DAC Learning Labs, communities of practice events, and other fora, all designed to share learnings and successes with healthcare systems around the globe.
Sarah Blugis is AAPA’s Internal Communications Manager. She can be reached at [email protected].
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