Evidence map›Paper›PMID 40242462›Full record

ArticleThe Lancet regional health. Western Pacific2025

Implementation of a best-practice model of care for cognitive impairment and dementia for first nations peoples attending primary care in Australia: a stepped-wedge cluster-randomised trial.

Jo-Anne Hughson, Zoë Hyde, Kate Bradley, Roslyn Malay, Harold Douglas, Sadia Rind, Kylie Sullivan, Lauren Poulos, Bridget Allen, Bonnie Martin-Giles and 23 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Lancet regional health. Western Pacific, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Advancing brain health equity with Indigenous peoples: A critical imperative.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

33 authors.

Jo-Anne HughsonDepartment of Medicine - Royal Melbourne Hospital, The University of Melbourne, Royal Park Campus, Administration Building 21, 34-54 Poplar Road, Melbourne, Victoria 3052, Australia.
Zoë HydeDepartment of Medicine - Royal Melbourne Hospital, The University of Melbourne, Royal Park Campus, Administration Building 21, 34-54 Poplar Road, Melbourne, Victoria 3052, Australia.
Kate BradleyDepartment of Medicine - Royal Melbourne Hospital, The University of Melbourne, Royal Park Campus, Administration Building 21, 34-54 Poplar Road, Melbourne, Victoria 3052, Australia.
Roslyn MalayWestern Australian Centre for Heath and Ageing, Medical School, The University of Western Australia, 35 Stirling Highway, Perth, WA 6009, Australia.
Harold DouglasDepartment of Medicine - Royal Melbourne Hospital, The University of Melbourne, Royal Park Campus, Administration Building 21, 34-54 Poplar Road, Melbourne, Victoria 3052, Australia.
Sadia RindDerbarl Yerrigan Health Service, 22 Chesterfield Rd, Mirrabooka, WA 6061, Australia.
Kylie SullivanNeuroscience Research Australia, 139 Barker Street, Sydney, NSW 2031, Australia.
Lauren PoulosNeuroscience Research Australia, 139 Barker Street, Sydney, NSW 2031, Australia.
Bridget AllenNeuroscience Research Australia, 139 Barker Street, Sydney, NSW 2031, Australia.
Bonnie Martin-GilesJohn Richards Centre, La Trobe Rural Health School, La Trobe University, PO Box 821, Wodonga, VIC 3689, Australia.
Rachel QuigleyHealthy Ageing Research Team, James Cook University, Nguma-bada campus, Smithfield, QLD 4878, Australia.
Sarah RussellHealthy Ageing Research Team, James Cook University, Nguma-bada campus, Smithfield, QLD 4878, Australia.
Diane Cadet-JamesHealthy Ageing Research Team, James Cook University, Nguma-bada campus, Smithfield, QLD 4878, Australia.
Valda WallaceHealthy Ageing Research Team, James Cook University, Nguma-bada campus, Smithfield, QLD 4878, Australia.
Wendy AllanNeuroscience Research Australia, 139 Barker Street, Sydney, NSW 2031, Australia.
Dawn BessarabWestern Australian Centre for Heath and Ageing, Medical School, The University of Western Australia, 35 Stirling Highway, Perth, WA 6009, Australia.
Kate SmithWestern Australian Centre for Heath and Ageing, Medical School, The University of Western Australia, 35 Stirling Highway, Perth, WA 6009, Australia.
Kylie RadfordNeuroscience Research Australia, 139 Barker Street, Sydney, NSW 2031, Australia.
Edward StrivensHealthy Ageing Research Team, James Cook University, Nguma-bada campus, Smithfield, QLD 4878, Australia.
Leon FlickerWestern Australian Centre for Heath and Ageing, Medical School, The University of Western Australia, 35 Stirling Highway, Perth, WA 6009, Australia.
David AtkinsonThe Rural Clinical School of Western Australia, The University of Western Australia, PO Box 1377, Broome, WA 6725, Australia.
Sandra ThompsonThe Western Australian Centre for Rural Health, The University of Western Australia, 167 Fitzgerald St, Geraldton, WA 6530, Australia.
Juliette CiacciaDepartment of Medicine - Royal Melbourne Hospital, The University of Melbourne, Royal Park Campus, Administration Building 21, 34-54 Poplar Road, Melbourne, Victoria 3052, Australia.
Louise LavrencicNeuroscience Research Australia, 139 Barker Street, Sydney, NSW 2031, Australia.
Belinda DuckerNeuroscience Research Australia, 139 Barker Street, Sydney, NSW 2031, Australia.
Tina HumphryDerbarl Yerrigan Health Service, 22 Chesterfield Rd, Mirrabooka, WA 6061, Australia.
Mark WenitongHealthy Ageing Research Team, James Cook University, Nguma-bada campus, Smithfield, QLD 4878, Australia.
Mary BelfrageDepartment of Medicine - Royal Melbourne Hospital, The University of Melbourne, Royal Park Campus, Administration Building 21, 34-54 Poplar Road, Melbourne, Victoria 3052, Australia.
Irene BlackberryJohn Richards Centre, La Trobe Rural Health School, La Trobe University, PO Box 821, Wodonga, VIC 3689, Australia.
Kate FulfordWestern Australian Centre for Heath and Ageing, Medical School, The University of Western Australia, 35 Stirling Highway, Perth, WA 6009, Australia.
Sharon WallNeuroscience Research Australia, 139 Barker Street, Sydney, NSW 2031, Australia.
Robyn SmithDepartment of Medicine - Royal Melbourne Hospital, The University of Melbourne, Royal Park Campus, Administration Building 21, 34-54 Poplar Road, Melbourne, Victoria 3052, Australia.
Dina LoGiudiceDepartment of Medicine - Royal Melbourne Hospital, The University of Melbourne, Royal Park Campus, Administration Building 21, 34-54 Poplar Road, Melbourne, Victoria 3052, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Dementia and cognitive impairment not dementia (CIND) are under-detected amongst First Nations peoples attending primary care. This trial implemented a culturally adapted best-practice model of care to increase detection and optimise management of CIND/dementia. Methods: This closed cohort open-label, stepped-wedge, cluster-randomised trial recruited 12 Aboriginal community-controlled primary health care services (ACCHSs) across urban, regional and remote settings in Australia. ACCHSs were eligible to participate if they conducted annual health checks, engaged in continuous quality improvement processes and had ≥55 clients aged ≥50 years. After a baseline control period, four ACCHSs were scheduled to enter the intervention phase every six months. During the intervention phase, ACCHSs were supported to embed best-practice dementia care through staff education and practice change initiatives. Co-primary outcomes were: (i) documented detection of CIND/dementia and, (ii) evidence of uptake of the diagnostic pathway measured as presence of ≥2 of: use of cognitive assessment tools, relevant pathology investigations, neuroimaging, and/or referral of clients with cognitive concerns to specialist services. Data were analysed with mixed effects complementary log-log regression. This study was registered with the Australia and New Zealand Clinical Trials Registry, ACTRN12618001485224. Findings: Between September 2018 and January 2019, 12 ACCHSs were recruited, comprising a sample of 1655 ACCHS clients aged ≥50 years (mean 60.3 ± 8.2 years), of whom 935 (56.5%) were female. One ACCHS withdrew during the study. After adjustment for time, the intervention did not show evidence of an effect for the first co-primary outcome (detection of CIND/dementia): HR = 1.53 (95% CI 0.64, 3.65). However, the intervention improved the second co-primary outcome (uptake of diagnostic pathway): HR = 2.34 (95% CI 1.05, 5.25). Intention-to-treat analyses yielded similar results. Interpretation: The co-developed best-practice model of care for cognitive impairment and dementia for Aboriginal and Torres Strait Islander people attending primary care improved the diagnostic CIND/dementia management process. Funding: National Health and Medical Research Council (Australia) and Dementia Training Australia.

Indexed as

Aboriginal and Torres Strait IslanderAboriginal community controlled health servicesCognitive impairment not dementiaDementiaModels of care

Identifiers

PMID40242462
PMCPMC12002872

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.