Dementia screening protocol for primary care in South America: a Delphi consensus study

Introduction: Rapid 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. Methods: A 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. Results: Consensus 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. Discussion: These 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.