Health and Social Care Pathways: Subjective Cognitive Impairment (SCI)
As explained in the general introduction to my research I am primarily referring to subjective complaints as SCI due to the many possible causalities e.g. depression, insomnia, menopause etc. I will refer to Subjective Cognitive Decline (SCD) when discussing the relationship between subjective complaints with the early identification of Alzheimer's disease.
When an individual presents to their GP/memory team expressing a concern that they are experiencing changes or difficulties with for instance their memory, they are more than likely asked to complete a test to assess their cognitive ability. Such tests will have a cut-off to identify if someone is possibly experiencing symptoms of Mild Cognitive Impairment (MCI) but not SCI/SCD. The tests are not sensitive enough to pick up such subtle cognitive changes.
Important queries that I am exploring:
When an individual presents to their GP/memory team expressing a concern that they are experiencing changes or difficulties with for instance their memory, they are more than likely asked to complete a test to assess their cognitive ability. Such tests will have a cut-off to identify if someone is possibly experiencing symptoms of Mild Cognitive Impairment (MCI) but not SCI/SCD. The tests are not sensitive enough to pick up such subtle cognitive changes.
Important queries that I am exploring:
- What happens when an individual presents to their GP/ memory team with subjective complaints that cannot be identified by standardised cognitive assessments?
- What level of awareness clinicians have of SCI/SCD?
- What views clinical teams have of early Alzheimer's disease diagnosis?
- What support is out there for individuals with SCI/SCD?
- What plans clinical teams have in order to deal with the ageing population, thus increases in service demand?
My past research...
Aims and objectives: to determine the levels of awareness about SCI as a construct in typical specialist clinical practice in England and Wales (i.e. by memory clinics/services) and what clinicians do when faced with individuals meeting the criteria for SCI.
An email was distributed to 112 memory teams in the UK requesting information on their most likely response to a fictitious patient profile. There was a 21% response rate which evinces potential time pressure within clinical services that may preclude research participation and/or a lack of issue salience at present. However, the data from those who responded provide an important insight into ‘where we are now’ in relation to this issue. Analysis revealed main themes associated with SCI, namely the factors that influence what action is taken when an individual presents and what further investigations are performed, the multiplicity of potential outcomes experienced, and the barriers clinicians may face. The findings highlight the need for a coherent and consistent framework in relation to the management of SCI.
This study has been published in: Jenkins, A., Tales, A., Tree, J., and Bayer, A. (2015). Are We Ready? The Construct of Subjective Cognitive Impairment and its Utilization in Clinical Practice: A Preliminary UK-Based Service Evaluation. Journal of Alzheimer's Disease, 48(s1):S25-S31. DOI:10.3233/JAD-150541
An email was distributed to 112 memory teams in the UK requesting information on their most likely response to a fictitious patient profile. There was a 21% response rate which evinces potential time pressure within clinical services that may preclude research participation and/or a lack of issue salience at present. However, the data from those who responded provide an important insight into ‘where we are now’ in relation to this issue. Analysis revealed main themes associated with SCI, namely the factors that influence what action is taken when an individual presents and what further investigations are performed, the multiplicity of potential outcomes experienced, and the barriers clinicians may face. The findings highlight the need for a coherent and consistent framework in relation to the management of SCI.
This study has been published in: Jenkins, A., Tales, A., Tree, J., and Bayer, A. (2015). Are We Ready? The Construct of Subjective Cognitive Impairment and its Utilization in Clinical Practice: A Preliminary UK-Based Service Evaluation. Journal of Alzheimer's Disease, 48(s1):S25-S31. DOI:10.3233/JAD-150541
Follow-up study
A follow-up study to the above is now complete. I interviewed willing team members of typical specialist clinical practices in England and Wales (i.e. by memory clinics/services) to find out more regarding what they know about SCI, what their current procedures are when someone presents with SCI, what their future plans are etc...
Please see below a You Tube video of me talking about the care pathways for people with SCI.
Please see below a You Tube video of me talking about the care pathways for people with SCI.