These results highlight the challenges of even basic cognitive assessment in a carehome setting. Routine assessment of all carehome residents using recommended tools may not be feasible, and even a short test battery is associated with substantial noncompletion and administration time. The three recommended assessments have differing purposes and do not necessarily have to be administered in sequence. The added test burden of performing all three assessments in a single session may have biased results particularly for the MoCA, which was always performed last. Accepting this caveat, the data would suggest that the AMT is a reasonable first screening assessment. The low completion rate and high prevalence of cognitive impairment at usual thresholds suggests that MoCA may not be suited to carehome settings. The measures of test suitability, acceptance, and completion suggest problems of feasibility of a universal cognitive screening approach. Suitability for assessment was not operationalized but rather was left to the discretion of the senior unit staff. It was felt that this approach mirrored real-world settings. Although NHS-CC is a UK-specific resource, the case mix will be similar to higher-level nursing homes and long-term care facilities, and so the findings have external validity.
Guido Maggiani, G. Fornelli, M. Bo
Journal of the American Geriatrics Society