Panel selection. The Quality Standards Subcommittee identified two team leaders to select committee members to participate in the creation of one or more practice parameters on dementia. The committee determined that three practice parameters were needed: Detection of Dementia, Diagnosis of Dementia, and Management of Dementia. The three practice parameter committees coordinated their literature searches to include key words such as specific forms of dementia and databases that interrelate the three topics. All panel members provided comprehensive disclosures of any real or potential conflicts of interests.
Literature review process. Search terms. Key and index words used were as follows: dementia, pre-senile dementia, senile dementia, vascular dementia, Alzheimer’s disease, early detection, early diagnosis, early stages, early symptoms, health screening, psychologic screening inventory, geriatric assessment, longitudinal studies, retrospective studies, mild cognitive impairment, Mini-Mental State Examination, cognitive impairment, cognitive assessment, and memory tests.
Databases. MEDLINE, EMBASE, Current Contents, Psychological Abstracts, Psych Info, Cochrane Database, and CINAHL Database were searched.
Inclusion/exclusion criteria and process. For the searches, the authors of the guideline sought studies in all languages; however, other types of studies were limited to English only. Studies were restricted to human subjects. Longitudinal prospective studies that evaluated mildly impaired subjects and followed them to detect cognitive impairment from 1991 to early 2000 were reviewed. The authors of the guideline also examined reviews and their bibliographies published from 1994 to November 1999 to identify additional articles. In addition, the authors of the guideline evaluated studies of clinical testing instruments that could be used to identify subjects with cognitive impairment.
Number and disposition of articles. The authors of the guideline identified 1,933 abstracts, which yielded 120 articles. Application of appropriate inclusion/exclusion criteria yielded 74 articles that provided the evidence for this parameter.