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South American experts reach consensus on some dementia screening protocol elements for primary careExperts reach consensus on some dementia screening steps for South American primary care

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Key Takeaway
Consider this South American expert consensus as a screening framework requiring clinical validation.

A Delphi consensus study involving 20 experts developed recommendations for dementia screening protocols in South American primary care settings. The study aimed to create a culturally sensitive framework to support timely detection and referral within person-centered approaches to healthy aging. No comparator was reported, and the study did not involve patient outcomes or clinical implementation.

Experts reached consensus (≥75% agreement) on several key elements: using an initial screening question, determining the duration of a brief screening battery, and defining primary care team roles in the screening process. However, agreement was not achieved on which functional assessment tools to use or on specific cut-off points for some screening measures. No quantitative effect sizes, absolute numbers, or statistical measures were reported for these consensus outcomes.

Safety and tolerability data were not reported, as this was a consensus development study rather than a clinical trial. The study's limitations include its reliance on expert opinion rather than clinical evidence, the lack of agreement on important screening components like functional assessment tools, and the absence of data on the protocol's effectiveness in actual practice. Funding sources and conflicts of interest were not reported.

For practice, this work provides a structured, flexible framework that may help standardize dementia screening approaches in South American primary care settings. However, clinicians should recognize these are consensus-based recommendations that require validation through implementation studies and clinical trials. The framework supports timely detection and referral but leaves important practical questions about functional assessment and specific cut-off points unresolved.

A group of 20 experts worked together to create recommendations for how primary care doctors in South America might screen for dementia. Their goal was to build a flexible, culturally sensitive framework to help with early detection and timely referrals for older adults. This type of study, called a Delphi consensus, gathers expert opinions to find areas of agreement.

The experts reached strong agreement on several key steps. They agreed that screening should start with a simple question, that a brief cognitive test battery should take a certain amount of time, and that different members of the primary care team should have clear roles. However, they could not agree on which specific tools are best for assessing a person's daily function, or on the exact scoring cut-offs for some tests.

It is important to understand what this study is and is not. This report provides a suggested plan based on expert opinion, not on evidence from a clinical trial that tested the plan with real patients. We do not yet know how effective this screening protocol would be in everyday practice. The lack of agreement on functional tools and some scores shows that more research and standardization are needed in this area.

What this means for you:
Experts agreed on a dementia screening framework, but its real-world effectiveness for patients is not yet known.

Study Details

Study typeGuideline
EvidenceLevel 5
PublishedApr 2026
View Original Abstract ↓
IntroductionRapid population aging in South America (SA) highlights the need for effective dementia detection strategies. Primary care is essential for early identification, yet no shared, regionally contextualized approach exists. This study aimed to develop expert-based recommendations for dementia screening in SA primary care.MethodsA two-round modified Delphi process involved 20 SA experts from different specialties. Round 1 explored open-ended and ranking questions on cognitive and functional screening tools, cut-offs, referral criteria, administration time, and professional roles. Round 2 sought consensus (≥75%) on items informed by Round 1.ResultsConsensus was reached on using an initial screening question to identify potential cognitive decline, the duration of a brief screening battery, and the primary care team’s roles. Experts emphasized the need for educational, cultural, and sensory adaptations and proposed strategies for patients without reliable informants. An agreement on functional assessment tools and some cut-off points was not achieved.DiscussionThese recommendations provide a structured, flexible, and culturally sensitive framework for primary care dementia screening, supporting timely detection, timely referral and integration into person-centered approaches to healthy aging, while highlighting areas requiring further research and standardization.
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