Doctor of Nursing Practice (DNP) Projects
Alzheimer’s Dementia Screening in Primary Care: Quality Improvement Project to Identify Those at Risk
Doctor of Nursing Practice
Family Nurse Practioner
Year Degree Awarded
Month Degree Awarded
Alzheimer’s, Alzheimer’s screening, outpatient, primary care practice, Alzheimer’s screening cognitive test, 65+ years
Dr. Cynthia Jacelon
DNP Project Chair
Dr. Cynthia Jacelon
DNP Project Outside Member Name
Margaret Hoberg, CNP
Background: Identifying Mild Cognitive Impairment (MCI) and Alzheimer’s Dementia (AD) in the Primary Care Practice (PCP) setting can initiate intervention early, before negative consequences occur including decreased quality of life and caregiver burden.
Purpose: To identify individuals at risk for AD and initiate early treatment and intervention. Methods: The Montreal Cognitive Assessment (MoCA) and Functional Activities Questionnaire (FAQ) were used as screening tools; adults age 65 and older were participants.
Implementation Procedure: Within the Internal Medicine Clinic, the standard annual wellness visits include Registered Nurses that administer a Mini-Cog screening tool with the patients. The Mini-Cog is a brief screening tool that is currently used in practice to screen for cognitive impairment using memory recall and a clock drawing test. The DNP student and Registered Nurses in the clinic, who have been trained by the DNP student, administered the MoCA and FAQ to participants who scored poorly on the Mini-Cog test during their annual wellness visits.
Results: With a two-tiered process instated, the sensitivity and specificities were improved with patients that failed the Mini-Cog and then went on to do screenings using the MoCA/FAQ.
Discussion: It is recommended to use the two-tiered process to initiate further screening with the MoCA/FAQ if a patient fails the Mini-Cog screening.
Implications into Practice and Conclusions: In practice, this may help to more efficiently and effectively screen for cognitive impairment and help patients receive referrals and/or further testing in a timely manner.
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