A team of researchers from Portugal (University of Porto), Ireland, Italy and Spain has validated a new eHealth tool to be used in screening programs for cognitive impairment, which is characteristic in dementia situations, for example.

The results of the validation work of this tool, called Qmci-P, were published in the journal Translational Medicine, under the name of its first author Pedro Machado dos Santos, researcher at CINTESIS – Center for Health Technology and Services Research/Abel Salazar Institute of Biomedical Sciences of the University of Porto (ICBAS).

“Quick Mild Cognitive Impairment (Qmci) is a brief screening instrument designed to differentiate the normal cognition of mild cognitive impairment and mild dementia. It is an evaluation scale sensitive to the whole spectrum of cognitive decline, validated in multiple contexts, countries and languages. It is ideal for rapid screening and consequent referral for a more comprehensive assessment,” explains the researcher.

Screening is done through an instrument with six subtests that assess cognitive dimensions such as orientation, language, or working memory. Compared to other cognitive screening instruments, the Portuguese version of Qmci is equally valid, but its application is faster: only 3 to 5 minutes, compared to 7 to 8 minutes of the MMSE and 10 to 12 minutes of the MoCA. Its brevity makes this instrument particularly suitable for future screening in the community, such as in Health Centers.

As the expert emphasizes, “dementia is an increasingly important challenge socially and from the point of view of public health. It has admittedly strong social and economic impacts if we consider the many hurdles to overcome along the way. However, its diagnosis tends to be late.”

“There are many subliminal changes that are not diagnosed, but that require care and that tend to worsen with time. However, in practice, cognitive changes in older adults are often underestimated and attributed to ageing, both by professionals and by the patients themselves and their relatives, who are discouraged from seeking help or reporting the symptoms,” he adds.

According to Pedro Machado dos Santos, “this work will allow health professionals to have access to a new instrument for the identification of older adults with cognitive decline or impairment at an early stage”.

In addition, “it will enable the development of multidimensional strategies that may delay cognitive decline or dementia and facilitate symptom management and control. In practice, we aim to contribute to a better staging of cognitive disorders, planning and adequacy of therapeutic interventions and, therefore, to improving the well-being and quality of life of people and their caregivers at each stage of the disease.”

In fact, “if timely identificated, we can tailor responses and improve support to patients and families. We will therefore continue to work on adapting the instrument to more realities and improving knowledge about its value, both in terms of the metric properties of the instrument itself and in its suitability to the evaluation protocols and the different contexts of care delivery,” reinforces the researcher.

The project was developed in the scope of the RAPid COmmunity COGnitive screening Programme (RAPCOG) twinning project, and it aims to implement de tool in other languages, besides Portuguese, which will allow the harmonization of practices. Part of this international group is Constança Paúl, CINTESIS research, and Director of the Department of Behaviours Sciences and Full Professor of ICBAS.

Dementia is a growing public health problem, associated with an increased risk of morbidity, high costs, and disability. The World Health Organization (WHO) estimates that there are 47.5 million people with dementia worldwide, which can reach 75.6 million by 2030 and almost triple to 135.5 million by 2050 .

At the national level, the latest epidemiological data indicate that there are 160,000 to 185,000 people living with dementia. The report “Health at a Glance 2017” places Portugal as the 4th country of the Organization for Economic Cooperation and Development (OECD) with more cases of dementia per thousand inhabitants. The OECD average is 14.8 cases per thousand inhabitants, and for Portugal the estimate is 19.9.