Dementia: Cognitive Assessment

ACP does not support QPP measure 281: "Dementia: Cognitive Assessment." Although this practice may help clinicians determine appropriate management of patients with dementia, there is a lack of high-quality evidence examining the impact of the assessment of cognitive status on clinical outcomes or on appropriate assessment intervals and it is unclear how clinicians should manage assessment results. Furthermore, the numerator specifications include cognition assessment tools that will not necessarily benefit clinical outcomes. It is burdensome for clinicians to adhere to a formal assessment protocol without evidence to support the benefit of the intervention on patient outcomes. A more meaningful measure may encourage assessments that are likely to lead to meaningful improvements in clinical outcomes. Furthermore, the numerator specifications include proprietary cognition assessment tools (e.g., Mini-Mental State Examination) that are not readily accessible to clinicians who practice in primary care settings.