Currently, the state attaches great importance to the development of early diagnosis and treatment services for cognitive disorders, and the preliminary community cognitive screening is the underlying foundation of the early diagnosis and treatment service system for cognitive disorders, as well as the primary barrier in the cognitive screening process, and the quality of its screening has a direct impact on the level of brain health of the elderly and the overall efficiency of cognitive screening.

To provide a reference for promoting the high-quality construction of cognitive disorders service centers by analyzing the development of preliminary cognitive screening services in Nanjing.

From December 2023 to August 2024, we visited the cognitive service centers in Nanjing, and 12 sample institutions that provided early screening services for dementia among the surrounding elderly population were taken as the research objects. The questionnaire included the basic characteristics of the organization and the status of the initial cognitive screening service development.

Basic characteristics of the institutions: 75.0% (9/12) of the sample institutions operated on the basis of elderly service organizations; the average number of months of cognitive primary screening services carried out in each sample institution was (16±6) months, and the average annual volume of screening services was (245±235) ; in terms of occupational category, nurses accounted for the highest proportion [36.8% (21/57) ] ; in terms of staffing, only 33.3% (4/12) of the sample institutions were staffed with both physicians and nurses. In terms of service content: 16.7% (2/12) of the sample institutions have adopted diversified screening methods for cognitive screening, and the types of cognitive early intervention services range from 3 to 7. Four (33.3%) institutions have penetrated the network of cognitive cooperative institutions, 5 (41.7%) institutions had plan to penetrate the network of cognitive cooperative institutions, but the service radiation scope of 16.7% (2/12) of the sample institutions is still limited to the community where the institutions are located. Only 66.7% (8/12) of the sample institutions provide cognitive early intervention services, and 75.0% (9/12) provided early follow-up services. In terms of the results of service development: the average annual screening rate of high-risk groups for cognitive disorders of the sample organizations is 28.85%, the average annual rate of early intervention for cognitive disorders is 60.97%, and the average annual rate of early follow-up for cognitive disorders is 70.94%. In terms of the source of funding, the funding for the cognitive screening program of the sample organizations came from the institutions themselves and government program subsidies.

Cognitive initial screening service system of Nanjing community cognitive service centers has begun to take shape, and early prevention and control of cognitive disorders have achieved certain results, but there are problems such as incomplete staffing, non-standardization of cognitive initial screening service, slow progress of cognitive initial screening service, and insufficient financial guarantee, etc. It is still necessary to improve cognitive prevention and control mechanism, strengthen cognitive prevention and control guarantee, and enhance social support to promote cognitive disorders service network construction and standardization management.

当前国家高度重视认知症早诊早治服务的发展，而社区认知初步筛查是认知症早诊早治服务体系的基础，也是认知筛查流程的首要关卡，其筛查质量直接影响老年人脑健康水平和认知筛查整体效率。

了解南京市认知初步筛查服务的开展现况，为推动认知症服务中心的高质量建设提供参考。

于2023年12月—2024年8月，对南京市全部社区认知症服务中心进行走访，以面向周边老年人群开展认知症早期筛查服务的12家机构为研究对象。采用课题组自行设计的机构调查表，收集机构的基本情况及认知初步筛查服务开展情况。

机构基本情况方面：9家（75.0%）机构依托养老服务机构运行；12家机构的认知初步筛查服务平均开展时间为（16±6）个月；平均年筛查服务量为（245±235）人次；配置的认知初步筛查服务人员中，护士占比最高[36.8%（21/57）]，仅4家（33.3%）机构同时配置了医生和护士。服务内容方面：2家（16.7%）机构采取多样化筛查方式进行认知筛查，认知早期干预服务种类为3~7种，4家（33.3%）机构已打通合作机构网络，5家（41.7%）机构计划打通合作机构网络，但仍有2家（16.7%）机构将筛查范围局限于所在小区；8家（66.7%）机构开展早期干预服务，9家（75.0%）机构提供早期随访服务。服务开展成效方面：12家机构的平均年认知症高风险人群筛出率为28.85%，8家机构的平均年认知症早期干预率为60.97%，9家机构的平均年认知症早期随访率为70.94%。资金来源方面，12家机构的认知初步筛查项目资金均来自机构自身或政府项目补贴。

南京市社区认知症服务中心认知初步筛查服务体系已初具规模，认知症早期防控已取得一定成效，但存在工作人员配置不全面、认知初步筛查服务不规范、认知初步筛查服务进展缓滞、资金保障不充分等问题，仍需健全认知防控机制、加强认知防控保障、强化社会支持以推进认知症服务网络建设与规范化管理。