Research Abstract: Free Paper - Oral Presentation Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting 2023

Preliminary results of the Let’s Chat (Community Health Approaches To) Dementia: An implementation program for detection of cognitive impairment and dementia in Aboriginal and Torres Strait Islander communities attending primary care (#74)

Jo- Anne Hughson 1 , Kate Bradley 1 , Zoe Hyde 2 , Mary Belfrage 3 , Eddy Strivens 4 , Leon Flicker 2 , Rachel Quigley 4 , Sarah Russell 4 , Kate Smith 2 , Kylie Radford 5 , Lauren Poulos 5 , David Atkinson 2 , Robyn Smith 1 , Sandra Thompson 2 , Kylie Sullivan 5 , Wendy Allen 5 , Bonnie Giles 6 , Roslyn Malay 2 , Irene Blackberry 6 , Dawn Bessarab 2 , Diane Cadet-James 4 , Valda Wallace 4 , Sharon Wall 5 , Mark Wenitong 7 , Kate Fulford 2 , Sadia Rind 2 , Bridget Allen 5 , Louise Lavrencic 5 , Dina LoGiudice 1
  1. University of Melbourne, Royal Melbourne Hospital, Parkville, VIC, Australia
  2. University of Western Australia, Perth, WA
  3. RACGP, Melbourne, Victoria
  4. James Cook University, Cairns, Queensland, Australia
  5. Neuroscience Research Australia, Sydney, NSW
  6. Latrobe University, Mildura, Victoria
  7. Lowitja Institute, Melbourne, Victoria

Background : High prevalence of cognitive impairment (CI) and dementia (D) coupled with low detection rates in Aboriginal and Torres Strait Islander communities has prompted research to improve detection and management of these conditions. One such project is Let’s CHAT Dementia in Aboriginal and Torres Strait Islander Communities, working in collaboration with 12 Aboriginal Community Controlled Health Services (ACCHSs) to implement a best-practice model of care through staff education and codesigned practice change initiatives.

Methods :Medical file audits of a sample of patients aged ≥50 years conducted six-monthly from late 2018 to January 2023 recorded: basic demographic information, presence of dementia risk factors (reported previously), detection rates and current care practices in relation to dementia and co-morbid conditions. Results Audits were conducted in 12 ACCHSs (1655 patient records) across four states.

This presentation reports on results available at time of writing (11 services; 1530 records). Patients’ mean age was 60.3 (range 50-95). At baseline, identified CI/D and documentation of concerns relating to cognition were 3.8% (n=58) and 8.9% (n=136) respectively. At study conclusion, rates of CI/D had doubled to 7.6% (n=116) and concerns documented had more than doubled to 20.3% (n=311). Concerns relating to cognition were most likely to be raised by a GP, followed by patients, and patients’ family members/carers. Care practices relating to brain health also increased: evidence of staff asking clients about their memory and thinking (from 27.6% to 49.2%), use of cognitive assessment tools (13.4% to 24.9%), laboratory investigations (4.4% to 7.8%), CT- or MRI-brain (4.8% to 13.4%).

Discussion/Conclusion While detection rates remain below the known prevalence in these populations (~20%), our findings indicate increased awareness and detection of CI/D across the sample. The upsurge in concerns raised is a promising indicator that ACCHS staff are implementing best-practice care guidelines imparted during the Let’s CHAT program